Half Z-plasty, band release, and cavity filling for correction of inverted nipple

Abstract

The aim of this study was to describe another technique using a half Z-plasty, band release, and cavity filling to correct challenging inverted nipples. In five nipples of three adult Korean female cadavers, the tensile strength of the lactiferous duct was measured. A half Z-plasty was designed below the nipple on the areola using a vertical long axis of 30°, 45°, and 60° for one flap and another of 90° with 15 silicone-made nipple protectors. In six inverted nipples of three women, a half Z-plasty, band release, and cavity filling was performed. The mean breaking strength of each lactiferous was 4.7 ± 2.3 N. The sum of the forces to break three ducts was 14.1 ± 6.5 N. The mean angle change of the nipple projection of the silicone model was 7.2° ± 0.3°, 9.4° ± 0.5°, and 13.4° ± 0.5°, respectively, in the 30°, 45°, and 60° flap. In all three nipples operated on, sufficient eversion of the nipples was satisfactorily obtained postoperatively. Releasing the inverted nipple was performed by severing the underlying tight fibrous tissue bands and canaliculi. The support of the nipple was maintained by propping and obliterating the dead space. This procedure was carried out through a half Z-plasty incision below the nipple on the areola.

Key Words::

• Nipples
• surgical flaps
• tensile strength
• human mammary glands

Acknowledgement

This study was supported by a grant from National Research Foundation of Korea (KRF–2008–521–E00002).