Breast Surgery for
Inverted Nipples
Inverted nipple is a condition in which a woman's nipples are turned inward rather than outward. For many women, this can represent a significant cosmetic defect, making them feel self-conscious and reluctant to undress in front of boyfriends or even their husbands. As with small breasts, sagging breasts, or asymmetric breasts, women can have their inverted nipples corrected surgically.
Causes of Inverted Nipples
Most inverted nipples, like over-prominent nipples, are congenital, i.e. from birth, and are genetic. If your mother or either grandmother had inverted nipples, it is likely you have them, too. However, inverted nipples can also be caused by a number of conditions that affect the breast behind the nipple, including:
- Mammary duct infection
- Injury to the breast
- Breastfeeding
- Breast diseases, including mastitis, breast abscesses, or breast cancer
Inverted nipples that occur during a woman's life are especially hard to deal with because they represent a sudden, negative change in a woman's appearance. If they occur as a result of breastfeeding, they can combine with other changes in appearance, such as weight gain and abdominal skin laxity to make a woman feel as if her entire body has been destroyed by pregnancy and childbirth.
Grades of Inverted Nipples
The degree of inversion of nipples has been classified into three major categories:
- Grade 1 nipples are typically inverted, but evert (emerge) readily in response to stimulation such as touch or cold temperature, and can remain everted for as long as stimulation lasts. These are often referred to as "shy nipples."
- Grade 2 nipples are harder to evert than Grade 1 nipples, and once everted invert again almost immediately.
- Grade 3 nipples cannot be everted. Infections can result from difficulties with nipple hygiene for women with grade 3 inverted nipples.
Inverted Nipples and Breastfeeding
Inverted nipples do not automatically mean that a woman is unable to breastfeed. After all, a baby achieves a good latch on the breast around the nipple, not on the nipple itself, and the suction from the baby is typically sufficient to stimulate milk secretion, including eversion of the nipple in most cases. Breastfeeding is not typically impaired unless the milk ducts are constricted behind the nipple, as is often the case if the inversion is due to injury or breast disease, and sometimes if it is congenital.
Correction of Inverted Nipples
Surgical correction of inverted nipples can provide permanent cosmetic improvement of a woman's breasts, making her less self-conscious and more comfortable with the appearance of her breasts.
Topographically, an inverted and an everted nipple are identical, but the inverted nipple is held inward by some form of tissue, such as scar tissue in the case of acquired inverted nipple or the smooth muscle normally responsible for eversion of the nipple in congenital nipple inversion. Because of the topographic similarity between the inverted and everted nipple, it is only necessary to rearrange smooth muscle in congenital inverted nipple to turn the nipple outward.
To correct nipple inversion, first the nipple is pull outward. Then an incision is made halfway around the nipple, and the tissue responsible for the inversion is either removed or rearranged. The nipple is sutured not only to close the incision, but to help hold the nipple out. Dissolving sutures are used.
The small incisions are virtually unnoticeable once healed. During breast surgery, care is taken to preserve the milk ducts so women who were previously able to breastfeed will still be able to following surgery. Unfortunately, many women whose milk ducts were obstructed as a result of inverted nipple will still be unable to breastfeed following surgery.
Read our Inverted Nipples FAQ for more information.
If you feel self-conscious about your inverted nipples, contact our plastic surgery office for a breast surgery consultation with Chicago Breast Surgeon Dr. Otto Placik today to learn more about correction of this condition.