Objective To observe the effect of continuous elastic outside distraction on the change of collagen content in female mini pig’s ni pples and their supporting tissues, and to investigate the mechanism of continuous elastic outside distraction correcting inverted ni pples. Methods Three 3-month-old female mini pigs (weighing 18.5-22.0 kg), which had 12 nipples, were employed. Four nipples of each minipig were not treated as control group (n=12), and the other nipples were continuously distracted with inverted nipple correction instruments as experimental group (n=24). The nipple specimens were harvested at 2, 4, 8, and 12 weeks after distraction and HE staining was performed to observe the change oftheir tissue structure. And saturated picric acid sirius red staining was used to observe the distribution and content of collagen types I and III, image analysis software for quantitative analysis. Results The control group had normal structure of epidermis at all time points. In experimental group, the epidermis thickened; basal cells, fibroblasts, and capillary significantly prol iferated along with the times; and the content and the density of collagen types I and III increased gradually. There were significant differences in collagen type I at 4, 8, and 12 weeks, and in collagen type III at 2, 4, 8, and 12 weeks between 2 groups (P lt; 0.01). There were significant differences in the ratio of collagen type I to III at 2 and 4 weeks between 2 groups (P lt; 0.05). Conclusion Continuous elastic outside distraction can increase the quantity of collagen types I and III in the tissue, the thickness of the dermis, and the height of the nipple, which may be one of key mechanisms of correction the inverted nipple by continuous elastic outside distraction.
To introduce a way to correct mildly and moderately inverted ni pple. Methods From May 2004 to January 2007, 16 patients (aged 18-38 years) with original bilateral inverted nipple were corrected with the double stitching of U-shape. Sixteen cases included 11 mildly inverted nipples and 5 moderately inverted nipples. Six of them received massage and vacuum aspiration, and the results were not satisfactory. After the pull ing out inverted ni pples, four microincisions about 0.1 cm on the border of areola and the basilar part of nipple were designed in each horizontal and perpendicular directions, then double stitching was performed to increase the supporting and sustaining tissue under the nipple and close the way nipple invert. Results Most cases exhibited excellent aesthetic projection and incision healed by first intention. Followup examinations were performed at 6 months to 2 years and revealed no evidence of recurring inversion, ni pple tilting or lactation disturbance. No surgical compl ications such as infection, nipple and areola of breast necrosis, permanent numbness. The scars in the local site were l imited and not conspicuous. Conclusion Double stitching of U-shape is easy and simple with few compl ications. It is an ideal method to correct mild and moderate inverted nipple.
Objective To introduce a kind of improved operative method for correction of severe inverted nipples. Methods Sixteen patients (aged 2838 years) with 31 inborn inverted nipples were operated with theimproved method from January 2002 to March 2005. The nipple was incised horizontally through the middle, the fibrotic band was released, and the tissue below the nipple was contracted. Then the defective space with mammary glandflap. Finally,a Zshaped suture was employed at each base of nipple. Results The shapes of these nipples were satisfactory. No infection and necrosis of the nipples occurred. The follow-up showed that the results were perfect in thesensory and ejective functions of nipples. All the corrected nipples did not have recurrence except one nipple. The scars in the local site were limited andunconspicuous. Conclusion Severe inverted nipples can be corrected effectively by the combined improved incisions and Z-shaped sutures. This method is suitable for the female patients with no requirment for feeding.
ObjectiveTo explore the effectiveness of self-made adjustable tractor for correction of inverted ni pple. MethodsBetween March 2005 and March 2011, 37 female patients with inverted ni pples (69 ni pples) underwent continuous traction with self-made adjustable tractor for 2 to 4 months. The age ranged from 18 to 46 years (mean, 23 years). Of 37 cases, 5 had unilateral inverted ni pple, and 32 had bilateral inverted ni pples, including 8 cases (15 ni pples) of mild inversion, 16 cases (30 ni pples) of moderate inversion, and 13 cases (24 ni pples) of severe inversion. The 2 cases (4 ni pples) recurred after traditional surgical method, and 1 case (2 ni pples) had infection because of severe inversion before traction. ResultsNo infection or hemodynamic disorder occurred during traction. All cases were followed up 6-12 months (mean, 8.2 months). Wound healed after traction in 1 patient (2 ni pples) with infection because of severe inversion; 2 recurrent cases (2 ni pples) were cured after re-traction; wire dislocation occurred in 1 case (1 ni pple), and was cured after changing traction position. The shape, sensation, and erectile function were normal after treatment with no scar. ConclusionContinuous traction with selfmade adjustable tractor is a good method for all the types of inverted ni pple. It is a simple, safe, effective, and minimally invasive method without scar.
ObjectiveTo investigate the effectiveness of rotation-embedding technology for treatment of moderate to severe inverted nipples. MethodsBetween March 2012 and March 2014, 24 patients (39 nipples) with moderate to severe inverted nipples were treated using rotation-embedding technology. The age ranged from 28 to 42 years (mean, 32 years). The bilateral nipples involved in 15 cases, unilateral nipple in 9 cases, including 30 moderate inverted nipples, 9 severe inverted nipples. The first time operation was performed in the other patients except 1 patient who had received corrective operation of bilateral nipples. ResultsThe operation was successfully performed in all patients; primary healing of incision was obtained; no swollen, bleeding, dehiscence, or blood flow obstacle occurred. All patients were followed up 5-24 months (mean, 12 months). The shapes of nipples were satisfactory; bilateral nipples were symmetrical basically; no nipple inversion recurred, and the nipple skins had good sensation. ConclusionUsing rotation-embedding technology can correct moderate to severe inverted nipples effectively.