Purpose: To correct inverted nipples
Length of operation: 30 min
Anaesthesia: Local anaesthetic
Inpatient stay: Nil
Followup: 1 week, 3 months
Time off work: Couple of days
Recovery: 7-10 days
Risks: Infection, Inability to breast feed, Loss of nipple sensation, Recurrence of problem
Inverted nipples are a frequent problem which can affect women at any period in life. Sometimes they are present from the teens, but self correct with pregnancy and breast feeding. If however there is a recent nipple inversion, then it is worth getting an urgent referral to the local breast clinic. This is primarily to exclude any other more serious breast problem.
Inverted nipples in most cases, is a perfectly benign condition which can be corrected by a simple, local anaesthetic day case procedure. The basis of the procedure is to divide all the milk ducts leading into the nipple, which are basically tethering the nipple down. Release of these ducts in effect lets the nipple stick out with correction of the problem.
Procedure
The procedure is done under local anaesthesia which is administered in the operation theatre. The nipple area is gently infiltrated till it becomes completely numbed. Following this an incision is made just adjacent to the nipple; the ducts and any scar under the nipple are completely released. This corrects the problem and the incision is closed with dissolving or removable sutures. The suture line is in the pigmented area of the areola and will ultimately leave an invisible scar in most patients.
A doughnut dressing is applied to avoid any pressure on the nipple and is changed after one week in the dressing clinic. Thereafter it is advisable to have a doughnut dressing cut-out to avoid direct nipple pressure for another 3 weeks. Subsequent to this, normal bras can be worn.
Complications
- Infection
- Inability to breast feed-The milk ducts are cut so it is not possible to breast feed.
- Loss of nipple sensation may occur as the nerves leading to the nipple may be partly or completely cut.
- Loss of nipple is extremely rare. This could result due to disruption of its blood supply which is avoided by careful technique.
- Recurrence of the problem is a possibility but fortunately uncommon.
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