This topic is about dealing with the challenges of managing output leakage and skin breakdown when you have a deep, inverted colostomy, often referred to as an "inny" stoma. After undergoing a colectomy, the person found themselves with a stoma that was not only unexpected but also problematic due to its recessed position. Despite efforts to manage it, the stoma's position has led to leaks and skin damage, complicating their treatment plan. Here are some suggestions and insights shared by others who have faced similar issues:

1. Consider using a "less-convex" one-piece or two-piece system. Some people have found success with a lower-profile convexity that adapts better to body movements, especially when sitting. This, combined with a protective sheet, can help reduce leaks and promote skin healing.

2. Try a skin-prep layering technique:
- Start by applying a skin protectant, like a barrier wipe or spray.
- Add a Bioderm barrier or strip on top.
- Reapply the skin protectant over the Bioderm layer.
- Once the pouch is in place, use a warm thumb to press firmly, particularly below the stoma and along the sides, to strengthen the seal for several minutes.

3. If possible, consider revision surgery or a surgical review. Ideally, a stoma should protrude at least ¾ inch (about 19 mm). If the stoma is too short and there are no anatomical barriers, another revision might help prevent ongoing leakage.

4. Manage your weight carefully. Weight gain can cause further retraction of the stoma. Some surgeons suggest avoiding weight gain or even losing weight before any additional revision or future reconnection.

5. Allow the skin some "air time" and shorten the wear time of your appliance. Changing the appliance more frequently and letting the area breathe during changes can help soothe irritated skin.

6. If leakage continues and surgery isn't an option, keep looking for an experienced surgeon or an ostomy-specialist clinic that can reassess the stoma's construction.

7. For those with stoma openings that have become too small or difficult to access, planned surgical enlargement or revision might be necessary. Sometimes, adjunct procedures like feeding tube placement are needed, and early referral can help prevent complications.