The normal nipple is cylindrical, protruding about 1.5-2 cm from the breast plane, showing a nodular shape. If the nipple is not higher than the breast skin and is not pulled up, it is called nipple invagination. Although this disease has no direct influence on marriage, it will affect the emotional communication and life of husband and wife, and it is inconvenient to breastfeed after delivery, which is easy to cause local inflammation and eczema, and can cause mammary duct dilatation in severe cases. So adolescent nipple depression should be corrected in time. Go to the hospital to check that it is not mastitis or other diseases, and then try self-treatment:
First, you can pull out the nipple sunken in the breast by hand and fix it for a period of time. If this method doesn't work, try syringe aspiration. Prepare a pair of 10 ml plastic syringes, and remove the shell at the front of the syringes; Pull out the needle core, turn the syringe upside down, and align the opening at the rear end of the syringe shell with the concave nipple; Then insert the needle core from the cutting position at the front end of the syringe, gently suck it, and use the negative pressure of the syringe to suck out the sunken nipple and fix it for 5-6 minutes; 65438+ 0-2 times a day.
At present, there is a "nipple lifter" on the market, the principle is similar to the later one, but it can be fixed for a longer time and can be worn for life and work. When treating with booster, start inhaling 1-2 times a day for half an hour each time. If there is no reaction, the adsorption time can be increased. Generally, you can suck out the nipple in about 30 days, and then consolidate the treatment for 2-3 months.
Usually choose a bra that is not too tight and has nipple space to avoid nipple pressure. If the above treatment methods are ineffective, you can go to the plastic surgery department of the hospital for surgery, and the effect is also very good, which will not affect your future marriage and breastfeeding.
Nipple invagination is not uncommon for girls before marriage, which has no effect on their health. Of course, they can get married, have children and build a happy family. Nipple invagination is not a serious illness, but if it is not corrected in time, it will often leave hidden dangers for the health of lactating mothers and babies, which should not be underestimated. Nipple invagination can be divided into congenital and acquired types. Congenital nipple dysplasia; The day after tomorrow, because of wearing a bra too early or wearing a bra too tightly in adolescence, the nipple can not develop or even shrink because of contraction and compression. Inflammatory contracture can also lead to nipple inversion. Nipple invagination can also be divided into true nipple invagination, nipple invagination and false nipple invagination. If the nipple is trapped in the milk scene and is not pulled higher than the old one, it is nipple invagination; If the nipple turns inward and cannot be pulled out, it is also called nipple invagination; If it is in the same plane as the breast skin, it is called flat nipple, also known as false nipple invagination. The above types of nipple invagination are due to the poor development of smooth muscle of nipple areola, and the nipple is not prominent because the nipple internal mammary duct is too short.
[Edit this paragraph] The harm of nipple invagination
Nipple invagination mainly has the following four hazards:
First, the nipple goes deep into the areola skin, and the local pits are not washed for a long time, and the secretions and pollutants are not removed, giving off a bad smell, which is easy to cause nipple areola inflammation, even bleeding and erosion, forming chronic inflammation;
Second, the nipple can't be exposed, the mother can't breastfeed, and the baby can't suck milk, which affects the baby's development;
Third, the poor discharge of maternal milk will lead to breast duct obstruction and milk deposition, which is prone to acute mastitis and breast abscess. If the mother never breastfeeds, it will also increase the chance of developing breast tumors;
Fourthly, nipple invagination is harmful to women's chest fitness and loses its proper curve.
Therefore, it is necessary to actively prevent and treat nipple depression. Girls should wear bras of appropriate size according to the size of breasts to ensure that nipples can develop well. You can open a hole in the front end of the bra corresponding to the nipple, and just squeeze out the invaginated nipple after wearing the bra. Nipple invagination can be corrected, and the timing of correction should be before delivery.
Mild nipple invagination can be treated conservatively first. Wash with warm water twice a day, and then gently pull the inverted nipple outward. Don't pull too hard to avoid damaging the nipple. You can also gently pull out when you wipe your nipple in the shower, and pull it repeatedly to make the nipple protrude. If you can't pull it out, you can put your thumb on both sides of the nipple and push it back and forth hard, three times a day, five times each time. After marriage, the man can suck his wife's inverted nipple. This kind of sucking can not only correct nipple invagination, but also prevent mammary gland inflammation, and of course make husband and wife's sexual life more harmonious. If nipple invagination is not corrected before delivery, a glass eye drop bottle can be used. The thick end is buckled on the nipple, and the thin end is connected with the syringe by a rubber tube. The air in the bottle is pumped out to make it negative pressure, and the nipple is sucked out. Take it off after a few minutes, and then pull it by hand to stop it from retracting. This method can be repeated if necessary. You can also use a 5 ml or 10 ml syringe to pull out the internal plug and connect it to the electric aspirator. Negative pressure of 400 ~ 500 mm Hg can suck nipples. You can treat 1 time every day and inhale repeatedly. The course of treatment is 20th 1, and some slightly invaginated nipples can also be removed. Severe nipple invagination needs plastic surgery to correct it. Under local anesthesia, several small diamond-shaped skin in areola were removed, and the fibrous tissue and smooth muscle of invaginated nipple were removed to make the nipple stand upright, and then ligation and suture were performed. The stitches were removed 7 days after operation, and then suction therapy 1 ~ 2 weeks was performed to prevent recurrence.
[Edit this paragraph] Correction method of nipple invagination:
If the nipple of an adult woman falls under the skin of the areola and does not protrude from the plane of the areola, when the part is mouth-shaped, it is called nipple inversion. The degree of nipple invagination varies, some only show nipple invagination, and the most serious performance is nipple depression or even inversion. Nipple invagination not only hinders the beauty of the breast, but also hinders the lactation function, and it is difficult to clean locally. The concave part is easy to hide dirt and accept dirt, which often causes local infection. The mammary duct is connected with the concave part, and inflammation can spread into the breast, causing mastitis, which should be corrected.
Nipple invagination is mainly congenital, but it can also be caused by trauma or surgery, breast tumor and fibroplasia after mastitis. The main cause of congenital nipple invagination is the dysplasia of smooth muscle of nipple and areola. These muscle fibers are pulled inward, and the lack of supporting tissue under the nipple forms nipple invagination. Entrapment usually occurs on both sides at the same time or unilaterally. The inverted nipple can come back as long as it is squeezed or pulled slightly, which belongs to mild nipple inversion, also known as reversible nipple inversion. This kind of nipple invagination can be corrected by non-surgical conservative treatment, and the best time for treatment is before marriage or early pregnancy. Specific methods include manual traction and instrument traction.
Hand traction: squeeze the nipple out of the skin surface by yourself, hold the nipple horizontally or vertically with your thumb and forefinger, and pull the nipple outward continuously or intermittently for about 30 minutes each time, alternating sides. 3-5 times a day. Instrument traction: that is, using the negative pressure principle to suck out the nipple with a manual or electric breast pump, or sucking out the nipple continuously or intermittently, 30 minutes each time, alternating on both sides, 3-5 times a day. After two months, the above two correction methods can get good results.
Irreversible nipple inversion, that is, severe nipple inversion, can only be corrected by surgery. The operation is to completely loosen the invaginated muscle fiber bundle and fill the surrounding tissue under the nipple, so as to enhance the supporting force of the nipple and make the nipple bulge and plastic. Surgery is generally performed under local anesthesia, and there are various surgical methods, which can be selected purposefully according to specific conditions. The operation is carried out in the areola, which is small and will not leave obvious surgical scars. Under normal circumstances, it will not damage the sensory nerve of the nipple, so it will not hinder the normal feeling of the nipple after operation. Surgery generally does not destroy the mammary duct, so it will not cause breastfeeding disorders.
[Edit this paragraph] Surgical treatment of nipple invagination:
The treatment of nipple invagination varies with the patient's age, invagination degree, postoperative breastfeeding requirements and local recurrence. Unmarried childless women often ask to keep breastfeeding function. Patients with local acute inflammatory reactions such as redness and swelling will suspend surgical treatment until the inflammation subsides for a certain period of time.
1. Conservative therapy
Because nipple invagination becomes more and more obvious with the development of adolescent breasts, the treatment of nipple invagination generally begins at about 1 8 years old. Before treatment, we should first judge the degree of nipple invagination, put two fingers around the areola, so that the nipple protrudes to the surface and squeezes to the middle. If the nipple can be squeezed out and can stay for several seconds, the application of negative pressure suction can correct the invagination deformity. For young women during puberty, physical therapy can be effective, and conservative treatment is the first choice.
The methods of continuous negative pressure suction include disposable syringes, continuous negative pressure suction devices sold in the market, and negative pressure balls for sucking milk. After sucking out the nipple, keep 1.5 ~ 20 minutes, several times a day, and stick to it. Those who are ineffective for more than 3 months generally need surgery.
2. Preserving mammary duct surgery
Suitable for patients with mild, moderate and severe depression. Before the operation, carefully wash the concave part with cotton swab dipped in hydrogen peroxide and normal saline to reduce the chance of surgical infection. The nipple root was anesthetized by local infiltration with 0.5% ~ 1% lidocaine containing a little adrenaline. It is documented that adrenaline is forbidden in nipple anesthesia, and there are no adrenaline-related complications in our clinical experience.
First, sew two stitches on the nipple with silk thread 1 to draw the inverted nipple. Cut the nipple horizontally along the direction of nipple depression, separate the mammary ducts in the nipple incision, and cut off the shortened fiber bundle between the ducts until the nipple does not retract after loosening the traction line. After the fiber bundle is loosened, the nipple still retracts inward, and it is often necessary to remove the middle part of the mammary duct until the deformity is corrected. Keeping several obvious mammary ducts during operation can lay a foundation for breastfeeding in the future. The complete release of shortened fiber bundles is the basic component of any surgical method, and it often recurs after incomplete release.
After releasing the fiber bundle, the lack of tissue filling under the nipple leaves a dead space, which is one of the reasons for the recurrence of postoperative infection. According to the degree of tissue defect, the following measures were taken: ① The small dead space was sutured directly to prevent the mammary duct from being blocked by suture. ② Design breast tissue flap to fill the dead space of nipple root, and pay attention to maintain the blood supply of breast tissue flap. ③ dermal tissue flaps were designed at both ends of the incision to fill the defect. After the nipple is sutured inside, the nipple is mostly narrow at the top and wide at the bottom. Z-plasty at both ends of incision can reduce nipple neck, improve nipple shape and further prevent nipple retraction and recurrence.
Pay attention to prevent nipple compression after operation, make a hole in the middle of dressing or sponge, put the nipple in, pull the nipple for 2 weeks, take out stitches after 1 week, and don't wear a bra for one month.
3. Breast duct cutting operation
Broadbent operation can be used for women who have given birth and will not consider breastfeeding in the future, or patients with local inflammation recurrence and severe deformity caused by scar traction.
The treatment before and after operation is the same as before. The scar at the bottom of the nipple is removed during surgery, and it is also removed when there is an inflammatory mass. Completely cut off the mammary duct, fully release the depressed nipple, and design a tissue flap to fill the tissue defect at the nipple root. Preventing the formation of dead space is the key to the success of this operation.