ORIGINAL ARTICLE BREAST SURGERY Inverted Nipple Treatment and Poliglecaprone Spacer Lidia Dessena 2 • Sandy Dast 1,4 • Simon Perez 1 • Razvan Mercut 3 • Christian Herlin 2 • Raphael Sinna 1 Received: 28 November 2017 / Accepted: 10 April 2018 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2018 Abstract Introduction Nipple inversion is defined as a non-projec- tile nipple. It is a frequent pathologic condition, in which the whole nipple, or a portion of its, is buried inward towards the lactiferous duct and lies below the plane of the areola. Numerous strategies have been described to correct nipple inversion. All the procedures have the purpose to give a good shape to the nipple, preserving its function and sensitivity, when it is possible. To avoid recurrences and to obtain good aesthetic results, we present a modified per- cutaneous technique. Method We performed a retrospective study between 2011 and 2016 and included all the cases of inverted nipples treated in our department. Our modified percutaneous technique consists of a minimal incision supported by a percutaneous suture as a temporary spacer to fill the defect caused by releasing the fibro-ductal bands. Results A total of 41 cases of inverted nipples were cor- rected in 32 patients. After 1 year of follow-up, no recurrence was observed and all nipples maintained com- plete eversion. There was only one case of partial unilateral necrosis in a patient who underwent tumorectomy and radiotherapy. All patients were satisfied with the aesthetic outcomes. Conclusion This is a simple, safe and cheap technique that should be considered as a reliable method for long-term correction of nipple inversion. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. Keywords Inverted nipple Á Percutaneous Á Poliglecaprone spacer Introduction Nipple inversion, firstly described by Astley Cooper in 1840 [1], is defined as a non-projectile nipple. It is a fre- quent pathologic condition, in which the whole nipple, or a portion of its, is buried inward towards the lactiferous duct and lies below the plane of the areola. Its prevalence varies from 2 to 10% of women [2, 3], and it is associated with aesthetic, functional and psychological consequences. It can result in functional difficulties in maintaining hygiene, continued inflammation or irritation and often inability to nurse. Moreover, this deformity can cause profound psy- chological distress with feelings of inadequacy and important psychosexual implications [3–5]. Clinically, nipple inversion can be congenital or acquired (sign of macromastia, mastitis and mammary carcinoma and after breastfeeding or breast surgery), Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00266-018-1139-5) contains supple- mentary material, which is available to authorized users. & Sandy Dast s.dast@hotmail.fr 1 Department of Plastic Reconstructive and Aesthetic Surgery, University Hospital of Picardie, Amiens, France 2 Department of Plastic and Craniofacial Surgery, University Hospital of Montpellier, Montpellier, France 3 Department of Plastic and Reconstructive Surgery, UMF Craiova, Craiova, Romania 4 Department of Plastic, Reconstructive and Aesthetic Surgery, Amiens University Hospital, Hopital Sud, 80054 Amiens Cedex 01, France 123 Aesth Plast Surg https://doi.org/10.1007/s00266-018-1139-5