A modified inverted nipple correction technique that preserves breastfeeding

Abstract

Background: An inverted nipple may affect the appearance of the breasts and breastfeeding, but traditional surgical procedures might injure the normal lactiferous ducts and damage sensory functions. Objectives: The aim of the study was to propose a minimally invasive and reliable method that preserves breastfeeding and corrects grade I and II inverted nipples. Methods: This was a randomized controlled trial of 230 female patients with unilateral or bilateral inverted nipples and 30 patients with normal nipples who visited the Preconception Counseling Department of our hospital from February 2009 to January 2016. The nipples in the distractor group underwent an operation with a distractor, while the control nipples were treated with daily exercises. The intervention lasted 6 months. The primary endpoint was full-term pregnancy breastfeeding for 4 months. The secondary endpoint was the completion of lactation without obvious complications, such as mastitis and nipple craze. Results: Grade I and II nipples achieved increased height after the distractor was worn for 6 months and at 37 weeks of pregnancy (P < 0.05), while the control nipples achieved only a marginal improvement at 37 weeks of pregnancy. In the distractor group, the success rates were 84.9% and 79.3% for grade I and II nipples, respectively, compared with the control group (52.5% and 38.9%, respectively) (P < 0.05). After treatment with the distractor for 6 months, nipples in the distractor group showed no complications, such as skin numbness or nipple necrosis. Conclusions: The use of a distractor is a reliable and minimally invasive method for correcting grade I and II inverted nipples while preserving breastfeeding.