Deformities of the nipple-areolar complex include a nipple, hypertrophy of the nipple, areola of too large diameter, deformation of the areola in the tubular mammary gland.
A retracted nipple can be congenital, but it can form after reduction mammoplasty or breast lift. The cause of congenital deformity is the underdevelopment of the ducts of the mammary gland and the contraction of the smooth musculature of the areola and nipple. The postoperative change in the shape of the nipple is the result of the contraction of the milk ducts as a result of the cicatricial changes in the foot of the nipple-areolar complex. Quite often, the involved nipple is combined with hypertrophy of the mammary glands. In any case, the solution to this problem is the intersection of the milk ducts at the base of the nipple.
Operation technique. A small incision is made at the base of the nipple at the 9 o'clock position on the conventional dial. The drawn nipple is pulled by a single-tooth crochet, and the ducts holding it inside the nipple cross. Then, with an elongated nipple at its base, a U-shaped seam is placed, located parallel to the access line. Sho-e removed after 5 days after the operation.
Serious anxiety can cause a woman hypertrophied long nipple. In addition to the aesthetically unsatisfactory relationship between the mammary gland and the nipple, the patient is often concerned about pain. Chronic trauma to the nipple can lead to its dysplasia and even malignancy. A long nipple can form both in hypoplasia and in hypertrophy of the mammary glands. Its length and diameter can reach 2 cm.
Operation technique. At a height of 5 mm from the base of the nipple on its surface make a circular incision to the muscle layer and ducts. Another circular incision is made 1 mm below the top of the nipple. Excess skin between access is excised, after which the ducts are telescopically inserted into the base of the nipple and a continuous seam is applied over its entire circumference.
- Deformation of the areola
An increase in the diameter of the areola up to 10 cm is often observed with hypertrophy and omission of the mammary glands. However, a decrease in the diameter of the areola may be required even with normal volume of the mammary glands, as well as with increasing mammoplasty.
Reduction of the diameter of the areola (including with increasing mammoplasty) is performed according to the method of L.Benelli.
Operation technique. The surgeon circularly cuts out the areola area, after which he applies a continuous intradermal suture with a No. 4/0 spill along its entire circumference. When tightening the edges of the skin collect in multiple small folds, which within a month straightened.
When the relatively wide area of the skin is removed, the differences in the length of the outer and inner edges of the circular wound become very significant.
In this regard, even a small rotational displacement of the edges of the wound relative to each other can lead to the formation of folds of the skin, which persist in the postoperative period.
Prevention of this complication is achieved by applying to the areola before the operation several radial lines, the comparison of which after excision of the skin area reduces the possibility of rotational displacement of the edges of the wound.
Tubular mammary gland. With the tubular mammary gland, the areola contour is elevated above the surface of the skin, and the purpose of the operation is to achieve a single contour of the gland and areola.
Operation technique. In the absence of ptosis of the gland, a strip of skin, which is telescopically implanted into the gland tissue, is circularly de-edema. The wound is circularly sutured with a continuous suture.
With the omission of mammary glands this operation is combined with increasing mammoplasty.
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