File:The breast- its anomalies, its diseases, and their treatment (1917) (14570410320).jpg

Identifier: breastitsanomali00deav (find matches)
Title: The breast: its anomalies, its diseases, and their treatment
Year: 1917 (1910s)
Authors: Deaver, John B. (John Blair), 1855-1931
Subjects: Breast Breast X-rays Breast Diseases Breast Neoplasms Radiotherapy
Publisher: Philadelphia, P. Blakiston's Son & Co
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons

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nipple. If too much forcebe appHed, it may be possible to do damage by rupturing one or more milk ducts, when,of course, there may be danger of the subsequent formation of galactocele. If but slightsuccess is met with, and the baby is unable to nurse directly, it may be possible to supple-ment and assist by the use of a nipple shield, but in most cases the child has to be arti-ficially fed. The question then arises as to what shall be done to prevent the sametrouble when the next child is to be nourished. To overcome the difficulty, operationmay be performed as follows: Operative Treatment.—Various operative procedures have been devised for the cor-rection of inverted and umbilicated nipples to which the term mamtnillaplasty has beenapplied. The technic devised by Axford is applicable alike to inverted and umbilicatednipples, while the other methods, which we shall describe, are to be used only in cases ofumbiHcated nipples. The Axford operation should be performed only on the non-
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FiG. 272.—Congenital inversion (umbilication) of the nipples. Case suitable for mammillaplasty. functioning breast; the other operations may be safely done in the early days of the puer-perium. Operative treatment is contra-indicated in those cases in which the nipplecannot be readily lifted from the depression in which it lies, and restored to its normalposition, without exerting undue traction. Mammillary inversion caused by neoplasticor inflammatory shortening of the ducts and peri-ductal tissues cannot be corrected byoperation. The principle underlying the Axford and similar methods of mamillaplasty is torestore the nipple to its normal position and to maintain it in that position by buildinga support of fibrous tissue beneath the base of the nipple. Axford accomplished this bypuckering the fascia. Others have made use of hare-lip pins or other mechanicalappliances, which are inserted beneath the nipple, and allowed to remain until naturehas formed an inflammatory buttress to se

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