1 in 10 women ( and men) will have their nipple withdrawn below the surface of the skin and may lack the normal projection. This may result in inability to breast feed and may also lead to women feeling self conscious with reduced self confidence. Inverted nipples varies from mild form where the nipples are occasionally inverted and are easily evertable to a more severe form where the nipples remain below the surface of the skin and cannot be made to protrude through the skin manually. Commonly both Nipples tends to be inverted but in some individuals just one nipple can be inverted. Most patients notice that their nipples have always been inverted since birth but nipples can invert later in life particularly after child birth and breast feeding or weight loss or can be associated with underlying breast cancer which usually affects just one nipple. If you are concerned you should see a breast specialist.
Severe form of Nipple inversion is corrected by a surgical procedure which involves a small incision at the base of the nipple to divide all the shortened milk ducts and application of retention purse string suture internally. The procedure is done under local anaesthesia as a day case . Mr Chandrashekar ,Surgical Director of Liverpool Breast Clinic will suggest the appropriate treatment after his assessment.
Before and after
After 2 weeks
After 6 weeks
2 weeks after surgery
6 weeks after surgery
What is inverted nipple?
Inverted Nipple is a condition where the nipples are withdrawn under the surface of the skin and may lack normal projection. This commonly affects both nipples but on occasion can just involve one nipple only.
Why do women have Inverted Nipples?
There are various reason why nipples can be inverted. In many women it is due to tight and short ducts which prevent nipple from attaining full and normal projection.
Can Men have inverted nipples?
Yes inverted nipples can affect as many men as women and can affect both sides or just one nipple.
What grade is my Nipple inversion?
Nipple inversion can vary in its severity from a very mild to a severe form. essentially there are 3 grades, Grade 1. In this mildest form the inverted nipples appear flat in flush with skin Surface and protrudes to full projection spontaneously or in response to touch or temperature change and remains protruding for a variable length of time. Grade 2 Inverted nipple is similar to grade 1 in appearance and do respond to touch and temperature change by protruding but this protrusion is short lived with the nipples retracting back under the surface of the skin. Grade 3 inverted nipple is typically remains retracted and cannot be manually everted and this is due to very shortened milk ducts and patients who have grade 3 inversion inversion are very unlikely to breast feed and this condition needs surgical correction. – there will photographs under each grade.
Can i breastfeed with nipple inversion?
Most women with Grade 1 and 2 can breast feed however those with grade 3 are very unlikely to have success at breast feeding.
What are my options of treatment?
Generally grade 1 and 2 doesn’t need any surgical intervention and if the symptoms are bothersome can try using Nipplet suction device. grade 3 will need surgical correction.
How long does the surgical treatment last?
The surgical treatment for both nipple inversion lasts from 40mins to 60mins but for one side correction , it would take under 30mins.
What kind of anaesthesia will i be given for the procedure?
Most patients have this procedure under local anaesthesia but a few would require Intravenous sedation in addition to the local anaesthesia. When the procedure is combined with breast augmentation the procedure is carried out under a general anaesthesia
What is the recovery time and downtime from work?
The operation is carried out as day case and the wound dressings is reviewed between 8 to 10 days. You can return to work within 2 to 3 days if it is an office/desk based job but if the work involves heavy lifting then 2 weeks off work will be desirable.
When can i return to gym and exercise?
Patients are generally advised to refrain from strenuous physical exercise for 4 weeks but power walking or mild stretch exercise is permissible from 1 to 2 weeks onwards.
Will there be a noticeable scar from the procedure?
The procedure is carried out with a small 3mm scar at the base of the nipple. Generally the scars in the nipple areola are well camouflaged by the pigmentation but in some patients it could be noticeable.
Will i have much pain after the procedure?
Nipple is a sensitive area and you may experience some discomfort once the local anaesthesia wears off but you will given appropriate adequate painkillers and should experience any severe pain or discomfort.
Will i be able to breastfeed after correction of the inverted nipples?
Generally it wont be possible to breast feed as all the ducts will be divided. In some cases where the patient desires to breast feed it will be possible to stretch the ducts and divide the scar tissue around it but this procedure is associated with some risk of failure to complete correct the nipple inversion nor could guarantee ability to breast feed.
When can i start driving after the operation?
Usually after 2 weeks.
Are the surgical results permanent?
In most patients yes but in rare occasion the scar tissue that develops after dividing the ducts can retract the nipple back in.
What are the complications of this operation?
Like with all surgical procedures, nipple inversion correction surgery is associated with complications such as Bleeding, infection, loss of nipple sensation and rarely either part of the nipple or the whole nipple can undergo ischaemic necrosis and die, leaving behind a scar with loss of the actual nipple. This is quite rare.
Will I be able to have my nipple inversion corrected with Breast enlargement? Or Areola reduction?
Yes nipple inversion can be corrected whilst having breast augmentation surgery or reduction of areola size.
How much does the procedure cost?
Correction of bilateral inversion costs – £2229.