Treatment of Inverted Nipple with Subareolar Abscess: Usefulness of High-Resolution MRI for Preoperative Evaluation
A 26-year-old woman. Inverted nipple with subareolar abscess (a). Sonography: the abscess was depicted as a hypoechoic area (arrow) (b). High-resolution MRI (contrast-enhanced T1-weighted image): abscess cavity (thick arrow) is hypointense structure with thin marginal enhancement. Small fistula (thin arrows) is hypointense linear structure associated with well enhanced inflammatory stroma (c). Surgical design. Dermal flaps were created at the neck of the nipple on both sides of the incision (arrows: before deepithelialization). The dermal flaps on both sides were marked for Z-plasty (d). Left: after excision, right: excised specimen (e). After completion of surgery, frontal aspect. The tip was not sutured to create roundness of the nipple (f). After completion of surgery, lateral aspect. The tip of the nipple was a raw surface (g). One year after surgery, frontal aspect. There was no recurrence of subareolar abscess (h). One year after surgery, lateral aspect. Since the neck of the rounded nipple was constricted, the nipple was less prone to reinvert (i).