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Articles

Inverted Nipple Correction

Scott W. Mosser, M.D.

article courtesy Scott W. Mosser, M.D.

CLICK HERE to visit the website of Scott W. Mosser, M.D.

Inverted nipples are a physical anomaly that commonly becomes apparent around the age of puberty in approximately two percent of the female population. Nipples can also become inverted due to breastfeeding when scar tissue distorts the milk ducts, shortening them and pulling the tip of the nipple inward. Nipple inversion also occurs in males, but more rarely.

The inverted nipple presents as a slit or hole in the breast, generally on both breasts if the condition is congenital, or may occur on one or both breasts if caused by breastfeeding. This distortion of the shape and symmetry of the breasts can be a cause of embarrassment and distress for many women, and the condition often goes untreated.

In the past, women with inverted nipples were reticent about demanding help; I now receive more frequent requests for information and help from women seeking a surgical solution. I am always pleased to inform them that their condition can be easily corrected, and I'm happy to explain the various surgical techniques available, depending on the severity of inversion.

The condition of inverted nipple is generally divided into three degrees of severity:

  • When the nipple is occasionally inverted and can be manually stimulated to project. The ability to breast feed is not usually compromised.
  • When the nipple is generally inverted but can be stimulated to project for short periods of time before inverting again. The ability to breast feed is more often compromised.
  • When the nipple is constantly inverted and cannot be released. Milk ducts are usually constricted and breast feeding not possible.
  • There are several plastic surgery techniques designed to release the inverted nipple so that it attains a normal projection, which improves the overall cosmetic appearance of the breast's areola-nipple area.


Things to Consider Before Surgery

If you are a candidate for surgical correction of inverted nipples, you will be reassured to learn that you have several options, and learning a little more about the various techniques available will help you make the choice that best suits your age, physical condition, and expectations.

One of the first considerations to discuss with your surgeon is whether you wish to breast feed in the future. If the severity of the inversion is such that breast feeding would not be possible in any case, then the surgical technique used would be primarily to create a cosmetically aesthetic shape and symmetry to the nipples of both breasts.

If the nipple inversion is less severe, then the surgical techniques used would focus on preserving or repairing the milk ducts with the aim of retaining as much as possible the capability to breast feed, and also attain a normal nipple projection. Not all surgeons offer each technique, so be sure the surgeon you choose is experienced and skilled in the procedure you want.

The Surgical Procedure for Correction of Inverted Nipples

The surgical correction of inverted nipples can be performed on an outpatient basis. A patient can opt for local anesthesia, intravenous sedation plus local anesthesia, or general anesthesia. Inverted nipple correction is frequently performed in conjunction with another plastic surgery procedure, such as a breast augmentation, breast reduction or breast lift.

The surgery begins with a small incision at the base of the nipple while the nipple is held in a protected projected state. Then there is a gentle separation of the fibers that are pulling the nipple inward. This is where a delicate touch is required to preserve milk ducts wherever possible.

Once the fibers have been separated and the nipple freed to extend to a normal projection, special sutures are placed internally to stabilize and strengthen the base of the nipple and helps retain its outward projection. Internal sutures dissolve with healing and don't require subsequent removal, and drainage tubes are generally not needed. The incision site is very inconspicuous and blends into the natural color of the nipple.

The Results Following Inverted Nipple Correction Surgery

Recovery from inverted nipple correction is very fast. Swelling is mild, usually with minimal or no bruising. Pain is minimal, with full recovery within a few days to a couple of weeks. Most normal activities can be resumed almost immediately. The results are permanent.

There is a renewed confidence that comes with a normal, balanced shape to the breast and nipples.

Depending on the severity of the nipple inversion and the extent of the surgery required, breast feeding capability may be fully or partially restored, a source of great satisfaction to many of my younger patients.

What my patients all invariably say is, "Why didn't I do this a long time ago!"


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