A New Method to Correct Inverted Nipple with Three Z-Plasty and Areolar Dermofibrous Flaps-Case Report

乳暈真皮組織皮瓣合併Z整形術治療乳頭凹陷之新術式－病例報告

潘致皓(Chih-Hao Pan) ； 黃文成(Wen-Chen Huang) ； 歐聖運(Shuan-Yuan Ou) ； 董光義(Kwang-Yi Tung) ； 游家孟(Chia-Meng Yu) ； 蔡明峰(Ming-Feng Tsai) ； 姚文騰(Wen-Teng Yao) ； 陳昱帆(Yu-Fan Chen)

《臺灣整形外科醫學會雜誌》 31卷3期 (2022/09) Pp. 181-187

摘要

Background: Inverted nipples may be congenital or caused by repeated inflammation and breast surgery. The incidence of this deformity ranges from 1.77% to 10%. Nipple inversion can result in serious aesthetic, functional, and psychological problems. Numerous techniques have been used to correct this deformity; however, complications including scarring, recurrence, lactiferous duct injury, and neurovascular injury have been reported. Aim and Objectives: We propose a modified technique with three Z-plasty and areolar dermofibrous flaps that correct inverted nipples without compromise of the neurovascular supply. Materials and Methods: A 31-year-old woman with bilateral congenital inverted nipples visited our clinic for surgical correction for aesthetic and breastfeeding purposes. We designed three Z-plasty and areolar dermofibrous flaps at the two, six, and ten o'clock positions around the nipple base, which were modified from the areolar dermal flap methods. Results: The patient was satisfied with the surgical outcomes. Good nipple projection and contour were noted, without complications. Conclusion: The modified technique with three Z-plasty and areolar dermofibrous flaps is easily performed and results in good aesthetic outcomes.

關鍵字

inverted nipples ； dermofibrous flaps

並列摘要

背景：乳頭凹陷可能是先天性或是後天原因，例如反覆發炎、惡性腫瘤或接受過乳房相關手術。乳頭凹陷的發生率約在1.77％到10％。其症狀往往影響女性患者的美觀、哺乳功能以及心理因素。目的及目標：分享以乳暈真皮組織皮瓣合併Z整形術治療乳頭凹陷之新術式，個案治療成功之案例以及回顧文獻探討乳頭凹陷的治療方式，拋磚引玉，以期乳頭凹陷的患者日後治療有更好的成效。材料與方法：病例報告：一位31歲女性罹患先天性乳頭凹陷，基於美觀與哺乳需求而尋求手術治療，我們藉由改良過去術式，而衍生出乳暈真皮組織皮瓣合併Z整形術來治療其乳頭凹陷。結果：術後追蹤矯治成效良好，患者在外觀與功能上都表示滿意。結論：乳暈真皮組織皮瓣合併Z整形術於治療乳頭凹陷係一兼顧美觀與哺乳需求的有效手術方法。