Inverted nipples are a common self-concern for many women and also a relatively aesthetic problem for the plastic surgeon.Many techniques for correcting inverted nipples have been reported, but none is totally successful. To avoid recurrence and to attain perfect shape of the nipple, the authors present a minimal-incision technique supported by "arabesque"-shape percutaneous sutures. First, four micro-incisions about 0.5?cm in size, each the circumference of the nipple, are designed horizontally. Second, after sufficient releasing of the loose connective tissue beneath the nipple, two 4/0 PDS sutures are made in perpendicular directions to increase the support and sustain the tissue under the nipple and to close the way the nipple inverts.This method was used to correct 22 inverted nipples of 18 patients classified as grade 3 or 4. The entire nipple remained everted and symmetric during a follow-up period of 3?months to 1?year except in two cases of recurrence during the early postoperative period due to a loose knot.The described technique is simple, safe, and reliable, providing sustained results over the long-term follow-up period with a high rate of stable eversion and patient satisfaction.
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