Inverted Nipple and Nipple Reconstruction: The ‘Parachute’ Flap

Abstract

The inverted nipple is a condition seldom discussed at length in standard works on breast surgery. The pathophysiology is a relatively short ductal system, which prevents the nipple from everting. Surgical procedures to correct the inverted nipple are divided into those that preserve ductal integrity and those that do not. Current techniques tend to be ineffective and are often complicated by a deformed nipple. A star-shaped flap is described which, when elevated by partial division of the ducts, looks like a parachute. Elevation allows collapse of the triangular flaps to form two concentric circles with a smaller diameter. The advantages of this technique are its simplicity, efficacy and lack of recidivism. The disadvantages are that it reduces the size of the areola and may result in a nipple that is too large. The method is also applicable to nipple reconstruction.