It is a very common condition that occurs in around 1 out of 10 men and women. It is often due to the milk ducts in the nipple being too short. These short milk ducts pull the nipple in, therefore not allowing it to protrude out naturally. This happens gradually and is often present since puberty since this is when the majority of breast changes occur. It can be present in one or both nipples.
An inverted nipple correction aims to correct the nipple so that it projects out in a natural way. To achieve this, your surgeon will either stretch the short milk ducts or cut them. This releases the tension that is pulling the nipple in, therefore allowing it to protrude out again.
Having a nipple correction can help boost self-esteem in patients, particularly when they are in intimate situations.
Why have nipple inversion surgery?
Although it is painless, nipple inversion can be a distressing condition that can affect self-esteem by making the breasts look distorted. It may also be an issue for women who are trying to breastfeed. This is because the baby may not be able to latch on to flat or inverted nipples to draw the milk out of the breasts. The ideal nipple correction candidates would therefore include those who are:
- Seeing little to no improvement using a non-surgical approach such as the Niplette device.
- Becoming distressed or self-conscious because of their nipple inversion.
- Having difficulty nursing their baby.
- Wanting an effective treatment with long-lasting results.
Nipple inversion grades
Nipple inversion can affect patients to different extents. There are different grades of nipple inversion depending on its severity. Your surgeon will examine you during your consultation to determine which grade of nipple inversion you have. The 3 grades are as follows:
Grade 1 (mild)
- The mildest form of nipple inversion
- This can also be called “shy” nipple
- Nipples may be flat or slightly inverted
- The nipples evert in response to stimuli such as touch or temperature
- Nipple protrusion remains for some time before they return back to their inverted state.
Grade 2 (moderate)
- The nipples are slightly more inverted than grade 1
- They will evert with manipulation but will immediately return to their inverted state when manipulation stops.
Grade 3 (severe)
- This is the most severe form of nipple inversion
- There is complete inversion of the nipples
How is a nipple correction procedure performed?
A nipple correction procedure is a relatively simple surgery to perform. It often lasts between 30 to 120 minutes depending on the severity of the inversion.
A nipple correction procedure involves the following steps:
1. Consent form
You will meet your surgeon to sign a consent form before the procedure. This will be done either on the day of your surgery, or during your pre-operative assessment a week before.
As this is a simple procedure, your surgeon will give you a local anaesthetic, with or without IV (intravenous sedation). In some cases however, it may be more preferable to use a general anaesthetic.
Your surgeon will make a small incision at the base of the nipple to gain access to the milk ducts that are pulling the nipple inwards. The different techniques your surgeon can use depend on the severity of the nipple inversion, and include the following:
Mild to moderate nipple inversion
In patients with mild to moderate nipple inversion, the surgeon can “stretch” the short milk ducts, therefore pulling the nipple outwards. Your surgeon will lift the nipple and areola from the breast, stretching them and then suturing the nipples into their new position.
As this method only stretches the milk ducts and does not cut them, it should not affect your ability to breastfeed. However, this technique does carry a higher risk of nipple inversion recurrence.
If your nipple inversion is more severe, your surgeon may choose to cut, or divide, the milk ducts. When the surgeon cuts the milk ducts, it releases the tension that is pulling the nipple inwards. Because the milk ducts are cut, this technique will affect your ability to breastfeed. You may lose the ability to breastfeed entirely. There is however, a much lower risk of nipple inversion recurrence.
After your surgeon stretches or cuts the milk ducts, they will use stitches to secure the nipple in its new projected position. Your surgeon will discuss with you which incision is best to use for your nipples.
4. Closing of incisions
Your surgeon will use stitches to close the incision. They will then apply a protective dressing to the nipple to prevent it from retracting again.
5. Return to the ward
The surgical staff will take you back to the ward to recover from the procedure and should be able to return home the same day.