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Grades of Nipple Inversion

Nipple inversion is a relatively common condition found in approximately 10% of the population that can occur on one or both sides. It is caused by the milk ducts within the glandular tissue in your breast. These ducts emerge onto the nipple, and when shorter than normal or shortened abnormally by other breast conditions, the nipple can be pulled into the breast. When the total pulling force of the milk ducts is greater than the erection force of the areola muscle, an inverted nipple appears. Nipple inversion can be classified into the following grades: 

Grade One

This is the least severe of the three grades. For grade one of nipple inversion, the nipple can be everted naturally or by physical manipulation to achieve a normal appearance. After a certain variable period of time, the nipple will invert back into the breast. Women with grade one nipple inversion can also observe that their nipples will protrude out, as normal, during breastfeeding, weight gain, menstruation, or pregnancy. Because the infant’s mouth creates a powerful suction force, it may be enough to pull the nipple out and overcome the forces of the milk ducts that hold it in. The Nipplette device works by a similar suction method, and when used regularly, nipple inversion may be permanently repaired. See the section under grade two for more information on this useful method.

Grade Two

Grade two is a bit more severe than grade one, since the nipple must be drawn out with greater force than for grade one inversion in order for it to protrude out. Even after it comes out of the breast, it still does not appear completely normal. On release, it either immediately reverts back to the inverted position or does so after a certain period of time. 

For those with grade two nipple inversion, breastfeeding may or may not be able to protrude the nipple. It is advised to try the Nipplette device prior to undergoing any form of surgical correction procedure. Nipplette works by suction and gently pulls the nipple out to an everted position. When suction is applied regularly, your milk ducts will lengthen and stretch out over time, allowing your otherwise inverted nipples to sit in a normal position and protrude outside the breast. This can be a simple and low-cost solution to grade one and sometimes grade two nipple inversion. However, if Nipplette does not work for you, you may need to seek a surgical solution.

Grade Three

Generally, grade three nipple inversion cannot be treated with Nipplette and is the most severe form of nipple inversion. In this case, the nipples are so tethered to the underlying breast tissue that they cannot be everted using physical manipulation with Nipplette. In fact, they are completely buried into the areola. The milk ducts connected to your nipple are either excessively shorter than normal or are very tight and pull on the nipple with a force much greater than the force of the areola muscles projecting the nipple outwards.

A surgical correction procedure is often the best solution to treating grade three nipple inversion. Feel free to browse through the details of our inverted nipple correction procedure and find out how it may benefit you.