A novel technique for nipple reduction surgery: the tripod wedge resection method

Abstract

Breasts are important for women in terms of both functional and aesthetic aspects, the latter of which can also have psychological implications. The nipple is one of the most important factors affecting the function and shape of the breast. Some women experience emotional distress associated with their nipple size or shape, especially if it is large or ptotic. The epidemiology of nipple deformity is unknown, but it seems to be common in Asian populations [1]. In women who experience psychological stress due to the shape of their nipples, nipple reduction surgery could be very helpful. There are four major surgical techniques for nipple reduction: circumcision, amputation, wedge resection, and flaps [2]. These four techniques are illustrated in Fig. 1. Each technique has advantages and disadvantages, which are mainly associated with the aesthetic outcome, preservation of lactiferous ducts, and complexity of the surgical technique. Although aesthetically unsatisfactory results and scarring/contracture have not been described for any surgical techniques, it is reasonable to presume that wedge resection and flap techniques may result in postoperative surgical scars due to their asymmetric design [3-5]. Regarding the patency of lactiferous ducts, which is especially important in breastfeeding women, circumcision, amputation, and wedge resection may impair the ability to lactate. Although the flap and wedge resection techniques involve complicated surgical techniques, we regard this aspect as a relatively unimportant issue when considering their more satisfactory outcomes. From the perspective of these considerations, we present a novel technique that has benefits in terms of its symmetric design, resulting in good aesthetic outcomes, and preservation of the lactiferous ducts, enabling breastfeeding. Young-Soo Choi, Hi-Jin You, Tae-Yul Lee, Deok-Woo Kim