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it."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":5,"max":10,"unit":"days","qualifier":"Early check of wound and nipple perfusion."}},{"purpose":"suture_removal","requirement":"conditional","after":{"min":7,"max":10,"unit":"days","qualifier":"If non-absorbable sutures are used; falls inside the stay."}},{"purpose":"result_review","requirement":"routine","after":{"min":60,"max":90,"unit":"days","qualifier":"Assessment of shape and projection."}}],"indications":["Inverted or retracted nipple","Enlarged or elongated nipple (nipple hypertrophy)","Asymmetry of the nipples","Nipple deformity after breast surgery or trauma"],"main_risks":["Recurrence of inversion or retraction","Reduced or lost nipple sensation","Impaired ability to breastfeed (milk duct division)","Nipple ischemia or partial necrosis (rare)","Infection, bleeding or hematoma","Visible scarring or asymmetry","Delayed healing"],"pain":"Mild to moderate discomfort for a few days, usually managed with simple oral analgesics.","preparation":["Consultation to assess nipple type and duct preservation goals","Discussion of breastfeeding plans","Medical history review and routine pre-operative assessment as indicated","Avoid smoking before and after surgery as advised","Follow surgeon's instructions on medications and skin preparation"],"recovery_timeline":[{"phase":"Days 0-3","description":"Mild swelling, bruising and tenderness; protective dressing or nipple shield in place.","restrictions":["Avoid pressure on the nipple","Keep dressing dry"]},{"phase":"Days 4-14","description":"Swelling settles; sutures removed or dissolve; wound care continues.","restrictions":["No tight bras or friction","Avoid heavy lifting and vigorous chest exercise"]},{"phase":"Weeks 2-6","description":"Return to normal activity; tenderness and sensitivity gradually normalize.","restrictions":["Resume strenuous exercise only when cleared"]},{"phase":"Months 3-6","description":"Scars mature and final nipple shape stabilizes.","restrictions":[]}],"rehabilitation_days":{"min":3,"max":7,"unit":"days","qualifier":"Ordinary functional recovery for daily activities after a minor nipple correction."},"result_longevity":"Often long-lasting, though inverted nipples may recur in some patients depending on technique and severity; hypertrophy correction is generally permanent.","revision_rate_pct":{"min":5,"max":20,"unit":"percent","qualifier":"Repeat surgery mainly for recurrent inversion; higher for severe inversion and duct-preserving techniques."},"scars":"Small scars at the nipple base or around the nipple, usually inconspicuous and fading over several months.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"One procedure per nipple pair, typically done in a single operative session."},"stages":[{"code":"nipple_correction","label":"Nipple correction procedure","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed at the initial session."}}],"qualifier":"Single-stage surgery for uncomplicated primary correction."},"success":{"metric":"Nipple projection maintained without recurrence of inversion","value":85,"unit":"percent of patients","horizon":"12 months","population":"Adults with mild to moderate inverted nipples, primary standalone correction","evidence_status":"limited"},"techniques":[{"name":"Inverted nipple release with duct-preserving technique","suits_whom":"Mild to moderate inversion, women wishing to preserve breastfeeding potential","recovery":"Recovery of about 1 week for routine activity."},{"name":"Duct-dividing release with purse-string suture","suits_whom":"Severe inversion with fibrosis, when breastfeeding is not a concern","recovery":"Similar to duct-preserving release, about 1 week to routine activity."},{"name":"Nipple reduction (wedge or circumferential excision)","suits_whom":"Enlarged or elongated nipples","recovery":"About 1 week to routine activity; sutures removed or absorbed in 1-2 weeks."}],"treatment_conditions":["outpatient"],"treatment_duration_hours":{"min":0.5,"max":1.5,"unit":"hours","qualifier":"Per procedure for both nipples in a standalone primary correction."},"initial_assessment_documents":["Front close-up photos of both nipples","Side-view photos of both nipples","Photos of nipples when stimulated or cold","Breast ultrasound or mammogram report (if available)"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single-stage outpatient surgery under local anesthesia; stay about 7-10 days to cover wound check and suture removal."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Confirm your surgeon discusses options, risks and benefits before you decide, so you can make an informed decision","scope":"procedure","source":{"url":"https://www.cuh.nhs.uk/patient-information/nipple-reconstruction/","host":"cuh.nhs.uk","quote":"Your surgeon will discuss with you the options, risks and benefits in order for you to make an informed decision.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C2","text":"Confirm a follow-up appointment is arranged after your operation to check wound healing","scope":"procedure","source":{"url":"https://www.cuh.nhs.uk/patient-information/nipple-reconstruction/","host":"cuh.nhs.uk","quote":"A follow-up appointment will be arranged for you one week after your operation to remove the dressing and check that the wound is healing properly.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C3","text":"Confirm the person who will do the procedure is the one you consult before deciding","scope":"treatment_type","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/choosing-who-will-do-your-procedure/","host":"nhs.uk","quote":"Always book a consultation with the person who will do the procedure before making your final decision.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C4","text":"Ask the surgeon to show before and after pictures of their work","scope":"treatment_type","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"They should be able to show before and after pictures of their work.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C5","text":"Find out whether the surgeon is fully trained in the procedure you want, since this can be hard to confirm abroad","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"It can be difficult to find out if a surgeon is fully trained in the procedure you want.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C6","text":"Ask how many similar procedures the surgeon has performed","scope":"procedure","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"how many procedures like the one you're having they have done","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C7","text":"Ask about the surgeon’s training and qualifications","scope":"treatment_type","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"what training and qualifications they have","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"Asked to pay for the procedure before any consultation has taken place","scope":"treatment_type","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/choosing-who-will-do-your-procedure/","host":"nhs.uk","quote":"Do not pay for a procedure until you've had a consultation to make sure it's right for you.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F2","text":"The clinic cannot show before and after pictures of its surgeon's work","scope":"treatment_type","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"They should be able to show before and after pictures of their work.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F3","text":"Cosmetic surgery offered on a website as part of a holiday package","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/advice/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"Be cautious of 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report","source":{"url":"https://www.leavale.nhs.uk/clinics-and-services/considering-surgery-abroad/","host":"leavale.nhs.uk","quote":"Ensure you receive detailed records of your surgery and aftercare plan","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":403}},{"id":"T2","text":"Home doctor needs the clinic's follow-up recommendations in a written discharge summary","document":"discharge summary","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"When you have treatment abroad, you must ask the treatment provider for their follow-up recommendations documented within a written discharge summary in English.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Ask for copies of all prescriptions before you leave","document":"prescription 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