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Inverted Nipple Correction

What is an inverted nipple?

An inverted nipple is pressed inwards and into the areola, the dark skin surrounding the nipple, instead of protruding outside the breast. It is the most common form of nipple abnormality, occurring in about 10% of the population. 

What causes my nipple to be inverted?

In almost all cases, nipple inversion is a congenital condition and occurs during development. An inverted nipple is pulled inwards when the milk ducts connected to the nipple from the glandular tissue within the breast are shorter than normal or are abnormally shortened in cases of breast cancer and other breast diseases. The combined force of the shortened milk ducts inwards is greater than the force of the areola muscles that push the nipple to protrude outside the breast, causing a net pulling force and leading to an inverted nipple.

Are there different types of nipple inversion?

There are, and the degree that the nipple is pulled inwards varies widely among individuals. There are three grades: grade one nipple inversion is when the nipple comes out during breastfeeding, weight gain, menstruation, or pregnancy. It can also evert during physical manipulation and will stay protruded and appear normal for variable periods of time. Grade two is when the nipple can be gently pulled out but immediately inverts once it is released. In this case, the nipple may not appear normal even when protruded. Grade three, the most pronounced form of inverted nipples, is when the nipple stays pushed into the breast and cannot be drawn out by any means. In this case, surgery is often the best way to correct it.

Why would I need such a procedure?

A pushed-in nipple may render a woman unable to breastfeed her baby, so seeking surgical correction can restore this ability. In addition to functional problems, if you experience anxiety, lack of confidence, discomfort, or self-esteem issues related to nipple inversion, then a surgical correction procedure can be the solution. The breasts are often seen as essential to a woman’s aesthetics, especially when she is wearing swimwear or other revealing or tight clothing. This may show an inverted nipple. In fact, psychological and cosmetic concerns are often root causes for those who wish to undergo inverted nipple correction.

What if my nipples on either side have different grades of inversion? 

That is fine and not uncommon. Your surgeon can perform the most fitting type of correction procedure for each nipple.

Is it possible for me to only have one nipple corrected for inversion?

Yes, it is an option.

So how exactly are my inverted nipples corrected?

First, the surgeon makes an incision near the base of the nipple. After this incision, your milk ducts are separated, teased apart, and lengthened as much as possible. If necessary, they will be divided. Surrounding tissue is used to create a scar that pushes and holds the nipple up in place. This 2 or 3mm scar is commonly on the lower outer border, the base, of the nipple or across the top of the nipple. It heals incredibly well and will hardly be visible. Because each individual has a different case of nipple inversion and preference for future breastfeeding, it is critical to discuss your best options with your surgeon during the initial consultation visits so you will have a clear idea of what the operation will entail. 

What will I feel during the procedure?

Our patients generally report feeling very relaxed and comfortable during the surgical process. It is a relatively quick procedure, but length may vary depending on the individual. It should usually take approximately 15 minutes per side. You may experience an occasional pulling sensation and a slight sharpness as the local anaesthetic is injected; however, this sharp feeling can be circumvented by applying an anaesthetic cream to the area prior to injection.

What kind of stitches will I need?

You may need cross stitches that run perpendicular to the border of your nipple, or purse string sutures that run parallel in and out. We will use absorbable stitches that will melt away and disappear naturally while you are recovering.

What are the side effects?

Slight discomfort from the nipples brushing against your clothes or bra may occur, and your nipples may appear slightly bruised, swollen, or have scars on them. For the vast majority of cases, these side effects are temporary and very mild.

What are the scars like? Do they go away?

After the surgery, you will see firm, pink scars for at least 6 weeks. These scars can remain the same size for a few months and can take up to 2 years to fade away completely.

Will I have to wear anything special after the operation?

Yes. We will provide you with a dressing which must be kept dry and worn for 5 to 7 days, at which time the affected area will be gently cleaned and checked to monitor your progress. It is also recommended to wear a soft, padded bra for two more weeks after the dressing is removed.

How long will I be able to go back to work and resume my daily activities?

The recovery period varies by individual, but most patients return to work after only a couple of days. We recommend to stick with walking and other light activities for 1 or 2 days and to avoid engaging in any strenuous activities for 7 to 10 days after the operation. The average recovery time is 1 to 2 weeks.

After my inverted nipples are surgically corrected, is there any chance that they will get pulled back in again? What should I do then?

No inverted nipple correction procedure is perfect and works consistently. Recurrence, however unlikely, is always a possibility regardless of technique, and individual results are highly variable. If your nipples happen to re-invert, a revision procedure may need to be done depending on the severity of the re-inversion and personal preference.

I do not want to go through a surgical correction procedure. What is a good alternative to correcting nipple inversion without surgery?

If you have grade one or grade two nipple inversion, you can try Nipplette. Nipplette is a simple, low-cost device that provides suction power to your pushed-in nipples and pulls them out. Over time, if used regularly, your milk ducts can lengthen and thus cause your nipples to protrude out as they normally would. However, this may not work in moderate to severe cases of nipple inversion, as with grade three and some more serious grade two cases where surgery may be necessary to correct the inverted nipple. It is best to consult with a doctor to determine which is the best option for you.

Will my nipples still be able to experience the same sensations?

Yes. It is very unusual for nipple sensation to be affected by the milk ducts. At most you may experience a temporary reduction in sensation or numbness following the surgery, but sensation should be restored during the recovery period.

Will I be able to breastfeed after the operation?

This depends on whether the surgeon cuts your milk ducts or not. If the ducts are cut, then you will not be able to breastfeed, but if the ducts are left intact, then there is a high possibility that you will still retain breastfeeding ability. The benefits of cutting the milk ducts is that the risk of recurrence of nipple inversion is much lower than if the ducts are not cut, and that it often offers a better correction of the more serious nipple inversion cases. We will be happy to discuss which option is best for you.

I am an older woman and I noticed that my nipples suddenly inverted. What does that mean for me?

Oftentimes, this simply means that your milk ducts have shortened over time and only recently have they pulled your nipples inwards. Nipple inversion can also happen after breastfeeding. It is better to have a doctor check this out, since it can be a sign of a disease or cancer in the breast that caused shortening of the ducts or some other abnormality that eventually led to an inverted nipple.

I am a younger woman and I noticed that my nipples suddenly inverted. What does that mean for me?

In the case where your breasts are still growing and developing, nipple inversion almost always reflects congenital short ducts that only began to pull your nipples inwards when the breasts began to develop. This is especially true for teenagers who are undergoing puberty.

Will this correction make me feel better about myself?

Inverted nipple correction and cosmetic surgery in general will help many improve their self-image and confidence, but it will by no means solve all your fundamental psychological and emotional issues. Keep your expectations realistic and you will be very satisfied with this operation and its results.

Will I see you after the procedure?

Yes. It is our policy to schedule regular follow-up examinations with your surgeon or a member of our nursing staff to continue monitoring your recovery.

Nipple Reduction

Why are my nipples so big?

Large nipple size is often congenital and occurs during development, similar to nipple inversion. Another common cause is breastfeeding, as nipple size can increase dramatically after an extended period of breastfeeding a baby.

How can I reduce the size of my nipples?

You can undergo a surgical nipple reduction procedure.

Is it possible for me to only have one nipple reduced?

Yes, it is an option.

How does this procedure work?

A surgeon can cut across the top of your nipple and reduce its vertical height. This operation has a very short recovery time, usually as fast as a few days. There are also a variety of methods to make your nipples less wide. Wedge-shaped pieces can be removed from different parts of your nipple and a surgeon can bring the remaining nipple around to replace the removed pieces. This leads to a decreased circumference of the nipple.

Will my nipples still be able to experience the same sensations?

Yes, in nearly all cases.

Will this correction make me feel better about myself?

Surgical nipple reduction and cosmetic surgery in general will help many improve their self-image and confidence, but it will by no means solve all your fundamental psychological and emotional issues. Keep your expectations realistic and you will be very satisfied with this operation and its results.

Will I see you after the procedure?

Yes. It is our policy to schedule regular follow-up examinations with your surgeon or a member of our nursing staff to continue monitoring your recovery.

Areola Reduction

Why is my areola so big?

A larger-than-average areola size is congenital and occurs during development, much like inverted nipples and large nipple size.

What is the areola and why would I want to have it reduced?

The areola is the dark skin surrounding your nipple. The average width of an areola is 4.5cm, so if yours is significantly greater then it may be visible when you wear a swimsuit or other revealing clothing. In this case, you may seek a surgical procedure to have it reduced. 

How does this procedure work?

Surgeons can create purse string sutures that run in and out parallel to the edge of your areola. These sutures, when pulled tight, bring together the edge of your areola like actual purse strings. This shrinks the size of the areola. Another technique is to use peri-areola scars around the nipple. 

After my areola size is reduced, is there any chance that it may enlarge again?

With any areola reduction operation, there is a chance that the areola will pull through the purse string sutures and stretch out a bit. The degree to which it enlarges after reduction varies by case, and permanent purse string sutures are used to decrease this risk.

Can I have areola reduction as part of a breast lift?

Absolutely. In fact, it is very common for areola reduction to complement breast augmentations. This not only ensures symmetry between the areolas but also is more convenient for the patient.

Is it possible for me to only have one areola reduced?

Yes, but keep in mind that the edge of the areola that was reduced will appear markedly more uneven and thus different from your other areola. Reduction on both sides creates symmetry and eliminates this problem. Prior to undergoing any procedure, it is important to discuss its pros and cons with your surgeon.

Will this correction make me feel better about myself?

Surgical areola reduction and cosmetic surgery in general will help many improve their self-image and confidence, but it will by no means solve all your fundamental psychological and emotional issues. Keep your expectations realistic and you will be very satisfied with this operation and its results.

Will I see you after the procedure?

Yes. It is our policy to schedule regular follow-up examinations with your surgeon or a member of our nursing staff to continue monitoring your recovery.