CPT® Code 19355

The procedure described by CPT® Code 19355 involves the correction of inverted nipples, a condition where the nipple is retracted into the breast rather than protruding outward. This condition can lead to breast asymmetry and may pose challenges for breastfeeding. Nipple inversion is typically categorized based on several factors, including the ease with which the nipple can be protracted, the extent of fibrosis present, and any damage to the milk ducts. For cases of mild to moderate nipple inversion, minimally invasive surgical techniques are often employed. These techniques include nipple piercing and the placement of sutures around the areola, both of which aim to preserve the milk ducts, thereby allowing for the possibility of breastfeeding post-procedure. In the nipple piercing technique, a metal bar is inserted through the areola, positioned directly behind the nipple, and secured in place. This piercing serves to prevent the nipple from reverting back into the breast tissue, and it is typically retained for a specified duration to facilitate the formation of scar tissue. Once the piercing is removed, the expectation is that the nipple will remain in a protracted position. Alternatively, the suture technique involves protracting the nipple and placing absorbable sutures around the areola, which are then tightened to reshape both the areola and the nipple. As the sutures dissolve, scar tissue forms around them, helping to maintain the protracted position of the nipple. In more severe cases of nipple inversion, a more complex surgical approach may be necessary. This may involve the potential sacrifice of milk ducts and could result in a loss of skin sensation. The procedure may include placing a suture through the nipple to ensure adequate protraction, making a small incision at the base of the nipple, and using sharp dissection to cut through the milk ducts and fibrous tissue. Following this, absorbable sutures are placed behind the nipple to keep it protracted, and the incision in the areola is subsequently closed. Overall, the goal of the procedure is to correct the inversion while considering the preservation of breastfeeding capabilities and minimizing complications.