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The pulled-in nipples

The pulled-in nipples – feature of development of a mammary gland at which the nipple is flush with an areola or it is inverted inside. The pulled-in nipples represent an esthetic and psychological problem for the woman, and also complicate breastfeeding implementation as the child cannot take pacifiers a mouth. Correction of the pulled-in nipples can be made in the conservative way (by means of a vacuum pulling) or by surgical intervention. Before an initiation of treatment it is necessary to exclude diseases of a mammary gland which can cause change of a shape of a nipple (for example, a breast cancer).

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The pulled-in nipples

Unlike well expressed nipples of mammary glands the flat or pulled-in nipples do not tower over an areola, and are with it at one level or are as if pressed into a breast. In the presence of the pulled-in nipples the problem carries not only esthetic, but also functional character. Appearance of the pulled-in nipples can negatively affect the relations with the partner. Functional problems can be connected with breastfeeding which in such situation is difficult to be carried out as it is difficult to child to take a breast with the pulled-in or flat nipple a mouth and to hold in sucking process. Maceration of an areola, and also a congestion in a mamillar hollow of fat and foreign mechanical particles can become other problems connected with the pulled-in nipples. The pulled-in nipples can be formed at hereditary predisposition, an underdevelopment and hypofunction of genitals, incomplete development of lacteal channels, long wearing a close bra.

On the surface of a nipple from 15 to 25 small lacteal channels going from a mammary gland open. Between them the soyedinitelnotkanny tyazh fastening to deeper layers of a mammary gland are located. Too short threads of bunches of connecting fabric promote retraction of nipples inside. In some cases feeding by a breast promotes stretching of bunches and giving to a nipple of the speaker of situation. Functional violations are noted at 50% of the patients having the pulled-in nipples.

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Classification of the pulled-in nipples

The plastic surgeon Slosser suggested to distinguish 2 types of the pulled-in nipples: densely inverted and disappearing.

The disappearing nipples are extended at sexual stimulation or when feeding by a breast; densely inverted (pulled-in) nipples never support areola limits. If the disappearing nipples cause only psychological and cosmetic problems, then existence of densely pulled in nipples is followed by also functional consequences: impossibility of feeding by a breast, inflammation or irritation of nipples.

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Not surgical treatment of the pulled-in nipples

For the purpose of correction of the pulled-in nipples not surgical treatment with use of the special vacuum nozzle imposed on a mammary gland can be applied. The nipple is greased with vaseline for sealing, from a nozzle pump out air, from above the bowl of a nozzle is fixed a surgical plaster.

The vacuum nozzle is carried during the day, removing for survey of a mammary gland on existence of cracks and irritation. For several weeks for which the treatment period lasts there is a lengthening of short bunches of connecting fabric and a pulling of a nipple forward. However at densely inverted nipples even prolonged use of a hardware technique is inefficient. The vacuum pulling of nipples can be recommended to patients at a presurgical stage.

Radical correction of a shape of the pulled-in nipples is made by means of plastic surgery.

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Operation on correction of the pulled-in nipples

Before planning of plastic surgery on correction of the pulled-in nipple the patient needs to be examined carefully as change of a shape of a nipple can indicate a number of serious pathologies of a mammary gland, including, a breast tumor.

For the choice of a necessary technique of plastic correction of the pulled-in nipples the patient needs to decide on whether she plans to carry out in the future breastfeeding as depending on it integrity of dairy channels can be kept, or operation will be limited to correction of cosmetic defect.

Correction of the pulled-in nipples represents rather small surgery and can be carried out under local or general anesthesia. If in the future breastfeeding is not supposed, then during operation the bunches of connecting fabric holding a nipple that is followed by its lengthening are cut. However, at the same time there is also a crossing of dairy channels making impossible subsequently breastfeeding of the child.

For preservation of integrity of dairy channels and their function microsurgical correction of a nipple is carried out. Through a small section at the basis of an okolososkovy areola with use of a microscope only soyedinitelnotkanny tyazh pulling a nipple inside are carefully cut. At the same time integrity of dairy channels remains, the nipple is delayed forward that provides a possibility of the subsequent feeding with a breast.

Correction of the pulled-in nipples can be carried out as independently, and in combination with mammoplastiky (tightening or reduction of a breast). Duration of operation on correction of nipples makes about one hour. At the isolated correction of the pulled-in nipples which is not followed by change of a form and the size of a breast, restoration after operation happens quickly.

Hypostases and bruises pass in several days, seams begin to live almost completely, within several weeks decrease in sensitivity of nipples can be noted. Postoperative restrictions include an exception of considerable physical activities, visits of a sauna, a sunbed, the beach within several months after carrying out correction of nipples. Esthetic results after carrying out correction of the pulled-in nipples are usually long-term.

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The pulled-in nipples - treatment should be carried out only under the supervision of a doctor. Self-treatment is unacceptable!!!

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