Inverted nipples have shortened lactiferous ducts and less fibrous and collagenous muscular
tissue and less connective tissue present, thus giving less bulk and less tissue for nipple projection.
Until now, many authors suggested various methods of correction of inverted nipple, but it shows that
perfect method does not exist. From July 2008 to December 2010, 41 nipples in 21 patients were
treated. 20 patients had bilateral inverted nipples. Under the local anesthesia with sedation, the
nipple was everted. A small incision was made on both lateral side at the nipple-areola junction. After
nipple traction, the lactiferous ducts and surrounding connective tissues were divided by sharp
dissection only through vertical direction. Upper and lower purse-string sutures using Nylon 4-0 were
performed for the maintenance of corrected nipple. The small incision was closed by the simple
suture. The operation time averaged 15minutes for each nipple. The mean follow-up period was 6
months. There were no complications associated with surgery, such as recurrence, infection, hematoma,
nipple necrosis and sensory loss. We applied modified purse-string sutures to mild and
moderate inverted nipple patients, and acquired good results. So we report our experience with a
review of literature. (Archives of Aesthetic Plastic Surgery 17: 119, 2011)