The reason for this malformation is found in the milk ducts, when they are too short or curl up on themselves. This congenital malformation is sometimes a source of difficulty for women who wish to breastfeed their babies. The baby may not be able to suckle. This malformation can be corrected by surgery.
Technique:
Under local anesthesia but in sterile conditions in the operating room, micro-incision of a few millimeters on the side of the nipple, then section of the galactophorous ducts which are retracted. A bursa is made to tighten the base of the nipple with absorbable thread. This technique has a low risk of recurrence, but in principle allows the patient to breastfeed.
For patients who no longer wish to breastfeed, a double de-epidermized flap or cartilage graft technique can be used to decrease the risk of recurrence.
Results:
Time to final results: immediate
Longevity of results: definitive
Before surgery:
Stop smoking 1 month before (essential, because risk of significant nipple necrosis for smokers.
Do not take Aspirin 10 days before surgery, inform Dr Lucas of any anticoagulant medication (Sintrom, Coumadin, Eliquis, etc..) to arrange for its discontinuation or replacement.
Intervention:
Pain: pain during the procedure will be almost non-existent, with an adapted anesthesia
Duration of the procedure: 45 minutes
Anesthesia: local
Location: operating room
Ambulatory (without hospitalization)
After the operation:
Post-operative pain: 1/10 often responding to Dafalgan
Social eviction: 24-48 hours of swelling
Suture removal: no sutures, surgical glue: shower possible from day 2.
Return to work: immediate
Return to sport: 10 days
Instructions:
Disinfection with Merfen disinfection for 7 days.
Preventive antibiotic therapy: Augmentin 1 g twice a day for 3 days.
Stop tobacco one month after surgery to prevent complications (nipple necrosis).
Shower from day 2: for 10 days do not rub the nipple, dry with clean cloth and dab.
Check-up by Dr Lucas 2 days, 1 week, 3 weeks, 3 months
Complications:
– Infection, hematoma
– Nipple necrosis: very frequent in smokers
– Recurrence: the malformation may return within 3 months after surgery, due to unpredictable abnormal healing of the milk ducts
– Alteration of sensitivity: normal for 1 week. Otherwise, sensitivity usually returns in the first few months.
– Breastfeeding: 20% of patients will not be able to breastfeed, due to unpredictable abnormal healing of the milk ducts
Alternatives and operations that can be combined:
Nipple augmentation can be combined with breast augmentation.
