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A Papuloplasty Video and Story

This 40 year old woman was very self conscious about her inverted nipple on the Left and asymmetry of papule on the Right. She had a procedure elsewhere that didn’t solve the problem.

When she saw me I assured her that I would be able to reverse her inverted nipple shape in the office, under local anesthesia. Because of her asymmetry and papule projection on the Left we agreed to do both sides at the same time.

The strategy was to do a nipple inversion procedure on the Left and see how large the diameter and projection that I could obtain. Using that information and outcome in real time, I would then be able to assess and then perform the Right papule reduction and diameter narrowing procedure in one setting. The results you are seeing are when I took off her nipple protecting shroud! She is thrilled!

Another Papuloplasty Story

This patient is a 38 year old woman who has been very, very dismayed with her nipple morphology for years. She had a procedure in another state that led to some soft tissue necrosis and a worse inverted nipple than she started with. She contacted my practice and I discussed with her the technical features of her surgery and she has consented to have a nipple inversion surgery on the left side and a nipple reduction on the right, both of which are called a papuloplasty but that have two separate problems.

The procedure was performed under local in my office and the first order of business was to un-invert her left nipple and pictured in a short video is a syringe with a suture through the tip of the nipple after it has been un-inverted and sutured at the base with a 4 mm incision and a rearrangement of the internal nipple contents to give her good projection of her papule. Once that dimension could be established surgically, then we turned to the right nipple for its reduction dimensions.

The right nipple needed to have telescoping of the diameter of the nipple to shorten its height and then about a 40% reduction of its diameter. The diameter reduction is kind of analogous to taking a slice of cake out of the cake and then closing the cake on itself with a little more internal rearrangements, which is considered the plastic surgical component of this procedure. Thereafter, the sutures are externally placed to secure it for about 10 days. Intraoperative video at the end of the procedure shows the symmetry of projection and volume.

She is going to protect her nipple and papuloplasty for a total of 10 days but she can shower starting postop day number 1 and just be careful when she cleanses herself.

She is obviously very happy when I took off her dressings as she spoke to us on day 5 after surgery in a video telling us all how happy she is with her bilateral papuloplasty.

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