乳头内陷（Inverted nipple）

乳头内陷（Inverted nipple） 乳头内陷(Inverted nipple) That female nipple, nipple is not out of the articular surface of the areola, and even depression sank on the surface, like a volcano like local phenomenon. brief introduction The degree of nipple depression varies from person to person, and the light person only shows different degrees of nipple retraction. The nipple can be squeezed out with the hand or the suction is negative, so that the nipple protrudes on the surface of the body. That is completely submerged in the leather, not being squeezed, often showed the reverse growth. Of course, these inner nipple, even if squeezed out, is generally smaller. Usually without obvious nipple neck. The incidence of female nipple retraction ranged from 1 to 2%. The extent of bilateral papillary invagination is not uniform, but can occur only on one side. It is a common female disease. Nipple deep in the areola, not only the appearance of indecent, but also because of the depression nipple can accumulate dirt or grease, causing itching, eczema or inflammation. Severe invagination makes it difficult for babies to suck their milk. Bring inconvenience and psychological depression to the patient. Degree classification Nipple shades can be divided into three categories: one is the part of nipple, nipple neck, can easily be extrusion, extrusion after nipple size with the ordinary people similar to class two, completely sunken on the nipple areola, but can hand out of the nipple, nipple is normally small, probably no milk of head and neck; three nipple completely buried in the areola below, can not make the nipples of extrusion. Cause analysis The common causes of nipple retraction are sagging of the skin and subcutaneous tissue, hypoplasia of papillary smooth muscle, shortening of the mammary ducts, and partial fibrosis of the tissue. Among them, shortening of the mammary gland and fibrotic contracture are the main causes of severe nipple retraction. The most common clinical observation of nipple retraction is primary papillary deformity. Primary causes of primary nipple retraction 1, the nipple and areola of smooth muscle dysplasia: nipple has the opening of the milk tube, milk tube around the smooth muscle fiber, the sunken nipple around the milk tube and into the dermal papillary muscle fiber bundle pulled inward. These bundles of texture and lactiferi have obvious difference. 2 、 the development of the milk duct itself is incomplete: the poorly developed milk duct fails to be manifested as a cord. 3, the lack of support under the nipple tissue support, but also the cause of nipple retraction. Two, secondary nipple retraction is the main reason Secondary nipple (acquired nipple deformity) are rare, pathological tissue within the breast nipple line by pulling or by unreasonable corset or wear tight bra cause. In inflammation, cancer and other diseases caused by the disease, the invasion of breast duct, ligament, fascia, the invasion of the catheter, ligaments and fascia contraction; unreasonable corset or wear tight bra occurs at a young age, with a chest tight, poor blood circulation, caused by the nature of the development of breast nipple after bad due to depression. In the acquired nipple retraction, the infection factor is one of the main factors of the nipple retraction. The main reason is that the mammary gland inflammation with fibrosis scar contracture affects its normal development and causes the nipple depression. Nipple abnormalities occur in breast malignancies, and the significance of this nipple deformity varies. In the original breast normal women, if there is no obvious reason for the nipple depression, mammography should be carried out and other examinations, to help the diagnosis of such cases of inverted nipple. Breast surgery can also cause nipple retraction, this nipple deformity. Reduction mammaplasty can cause nipple retraction due to tension and scar contraction. The most common causes of nipple depression are as follows: 1, too tight clothing bundle. Especially women in the chest * development period, underwear too tight, easily lead to nipple depression. 2, improper use of bra. Bra too small, too tight, premature use will cause nipple depression. 3, nipple depression and genetic also have a certain relationship, clinical observation of mothers and their mothers, generations of Chinese and grandma have nipple depression history, the next generation suffering from nipple depression may be higher than normal people. Edit the adverse effects and hazards of this paragraph 1, nipple retraction is easy to cause nipple areola inflammation and mastitis disease The nipple, areola after compression of lymphatic vessels, causing lymphatic flow barriers, collagen tissue exudation, at the same time, because the nipple, nipple and areola surface shedding of epidermal cell secretion cannot be cleared in time the skin caused by stimulating the nipple, nipple and areola inflammation. Serious nipple retraction, resulting in invagination of mucocutaneous mucosa, accompanied by eczema, and some patients with bleeding and erosion, forming a chronic inflammation. The mammary duct is connected with the invagination, and the inflammation can spread to the mammary gland. The retrograde infection causes mastitis. If the nipple is not caught in time to correct, long-term inflammatory stimulation, resulting in mammary duct contraction due to chronic inflammation, nipple depression is more serious, easy to form a vicious cycle. 2 、 nipple retraction seriously affects breast feeding Whether the nipple is flat, sunken or inverted, May cause postpartum breast-feeding difficulties. If the nipple development abnormalities, especially the nipple depression, will inevitably affect the neonatal bonding and sucking, making postpartum breast-feeding difficult or unable to breast feeding. At the same time, because the baby can not receive the mother's nipple, milk can not be sucked out, the newborn prone to dehydration heat. Nipple depression of women, often due to pregnancy breast development and maternal secretion of milk, breast more swollen, nipple depression further aggravated, women will be due to their own deficiencies, and give up breastfeeding. 3, nipple affects health and maternal postpartum recovery of infants Infants can not get breast milk feeding, affecting the development of the baby, the body health is also affected. 4, affecting the beauty of the breast Nipple retraction is detrimental to women's chest, losing the proper curve and affecting the beauty of the breasts. 5, affect sexual life Nipple is a very important sexual sensitive point for women. Many women's sexual desire is achieved through nipple stimulation. Once the nipple is sunken, it is difficult to play an effective sexual stimulation, and even affect the man's sexual desire. 6, affect the patient's mental health Chronic anxiety, worry and lack of confidence in one's own body seriously affect women's mental health. Correction and Prevention correct Experts point out that nipple retraction is mainly congenital, but can also be caused by trauma or surgery, breast tumors, and fibrous hyperplasia after mastitis. Congenital nipple retraction is mainly caused by the smooth muscle development of the nipple and areola. These fibers are pulled inward, together with the lack of supporting tissue in the nipple, which results in the nipple retraction. Invagination is usually bilateral and unilateral. Inverted nipple, such as a little squeeze or pull the nipple can be back, that is, mild nipple depression, can also be called "inverted nipple". Correction of this kind of inverted nipple can be performed by nonoperative conservative treatment. The timing of treatment is best before or during the first trimester of pregnancy. The specific methods include manual traction and instrument traction. And the breast is a beautiful woman the focus, while the nipple is the focus on "bazaar". If you find the nipple depression, women had better correct in time. The following methods can be chosen according to different situations. First hand pull. Adolescent period is an important period of breast development, but also an important period to correct nipple depression. Always pull the nipple, can make breasts prominent, the skin around the support force increases, play a "fixed" effect. Several times a day. For a long time, the nipple naturally gradually outward bulge. If you can not pull out, you can first push the skin of the breasts near the nipple. Two is the attraction therapy. After the pregnancy, the daily application of breast pump to attract the nipple several times, prompted by the negative pressure bulging papilla. Three is to use the nipple correction device, is treatment nipple flat or sunken. Prevention First, any mother, aunt and other immediate relatives of women have nipple depression, should be the focus of prevention. A girl with a genetic predisposition may be able to lift her small nipple outward 1~2 times a day after birth. Attention must be gentle, it is better to have experienced operators. In this way, you can see the baby nipple is green bean or small disk shaped higher than the skin, the future will be greatly reduced the chances of nipple collapse. Secondly, pay attention to dress. Cotton underwear should be, and often change, the sunlight. If there is a sign of redness and tear in the nipple, the underwear should be cooked and sterilized. It is not too early for the girl to use a bra. Third, to prevent extrusion. Underwear, bra appropriate, not too tight, for the larger breasts of girls, more attention should be paid to loose breasts. For girls prone to the habit, we must promptly correct, to prevent nipple extrusion, so as not to increase the degree of nipple depression. Women suffering from nipple collapse should pay special attention to the health care and hygiene of the nipple after delivery. Hangzhou inverted nipple correction experts said that the nipple has a slight depression, the appropriate increase in the number of infants sucking, while focusing on the protection of nipple, pay attention to breast cleaning, beware of infection. Once the nipple redness and swelling, should promptly go to the hospital for treatment, to prevent formation of mastitis. Surgical correction Overview of corrective surgery There are many kinds of methods for correcting inverted nipples. According to the degree of depression, we can choose the method which can not leave obvious surgical scars, and has less possibility of recurrence and can keep the function of lactation. Surgery usually under local anesthesia, in the areola to do three to four radial incision, relax, causing the nipple depression reasons, re shaping the nipple. Because the method of correcting the depression of the nipple is complicated, it is necessary to communicate well before the operation. Operation principle (1) loosen the fibrous bundle that causes the nipple to collapse and, if necessary, cut off some or most of the shortening of the mammary duct. (2) tissue transplantation fills empty papillae. (3) make a narrow ring at the neck of the nipple, Prevent tissue from filling into an empty nipple. (4) make flap graft when necessary, increase nipple or make nipple neck. (5) do 1~2 of the nipple traction after surgery to prevent recurrence of inverted nipple. Operative points (1) purse string nipple plasty: a circular incision of 1.5 ~ 2.0cm diameter was designed at the areola center, and the skin was incised. With a sharp knife around the nipple in the flap with deep surface annular incision, to release the contraction of smooth muscle fibers, the nipples pull up edge skin purse string suture and taut knot. Proper strength to avoid blood disorder. Then suture the two margins to form a new nipple, [1]. (2) fusiform incision nipple reconstruction: fusiform incision in the breast monitor heart, ease of contraction of smooth muscle fibres, the nipples pull separation on both sides of 1/3 flap, 1/3 blood retention center zone, and then concentrated to the center to form a new nipple suture. (3) breast rhombic skin resection: nipple centric painting 3cm diameter circle, cross circle inside and outside the mark 3 diamond incision in equal distance apart, the diamond in the skin and subcutaneous tissue after resection, but the formation of 3 pedicle flap. To do throughout the nipples of traction line traction nipple, with a knife around the nipple in the flap with deep surface annular incision, to release the contraction of smooth muscle fibers, the nipples pull through 3 incision a pouch suture in the subcutaneous ligature should be tight instead of loose, then the diamond cut suture. Edit this paragraph Operation mode The common surgical procedures are as follows: 1.. The operation of preserving the mammary duct is suitable for the patients with mild, moderate and severe depressions. The cotton swab was dipped in hydrogen peroxide and saline to clean the sunken area before operation, and the chance of surgical infection was reduced. Local infiltration anesthesia was performed at the root of the nipple. 2. mammary gland catheter cutting operation, has already been born, will not consider breast-feeding women, or local inflammation recurrent attack, scar traction serious depression deformity of patients, can use this method. Before and after the operation, the same method as before. Surgical removal of the scar at the bottom of the nipple and removal of the inflammatory mass. Completely cut off the mammary duct, loosen the depressed nipple sufficiently, design the tissue flap to fill the root tissue defect of the nipple. This surgery is generally performed under local anesthesia and operation varied according to the specific circumstances, to choose, the surgery was done within the areola, smaller scar surgery, not obvious, under normal circumstances, will not damage nipple sensory nerve, so surgery will not impede the normal sense of the nipple. Surgery generally does not destroy the mammary duct, so it will not cause lactation disorders. Operative notes 1. Do not take aspirin containing aspirin for two weeks before surgery because aspirin can reduce platelet clotting function; 2, suffering from hypertension and diabetes patients should be informative in the first visit to the doctor told the disease, in order to open the doctor confirmed the operation plan; 3, before surgery to determine physical health, no infectious diseases or other physical inflammation; 4, menstruation, pregnancy, breast-feeding 6 months should not surgery. 5. Avoid the upper arm lifting after operation, and bandage the upper part of the chest when necessary; 6, 4-5 days after surgery can start breast massage, extrusion in all directions, sooner or later each time, in order to prevent capsular contracture; 7, take appropriate amount of vitamin E after surgery, such as found that the wound redness or swelling of a small amount of exudate, subcutaneous hair hard, can be physical therapy; 8, one week after surgery should avoid sexual life, and then a month after the breast to be extremely careful.