The Answer to Your “Fixing inverted nipple” Search

I’m happy to say that I can answer that Google query.

You’re not alone.  This issue is a fairly common, and one that is not often talked about.  It occurs in both men and women, and may cause people to feel self-conscious during intimate situations or at the pool/beach.

Inverted nipples may be present at birth, and typically become more apparent at puberty with growth and development.  The breasts grow, but the ducts/connecting tissue fibers tether the nipples inward causing the “innie nipple” appearance.  Of special note, if you are well past puberty and have only recently developed an inverted nipple, this may be a sign of an underlying condition in the breast, and you should have this evaluated by a medical professional.

Like seemingly everything in plastic surgery, there is a grading scale to the deformity.  If you are able to “pop out” the nipple easily and it stays out, this is Grade 1.  If you can “pop out” the nipple with a bit more difficulty, but it retracts back in when pressure is released, this is Grade 2.  If the nipple stays in despite maneuvers to pop it out, this is Grade 3.

There is a great surgical technique that can correct inverted nipples.  The technique was pioneered in France, and is simple, safe, and quick.  Since it involves dividing the tethering bands/ducts that contribute to the inversion, it is best for Grade 2 and 3 inverted nipples.

First, the normal nipple is carefully and precisely measured.  These measurements will be used to fix the inverted nipple so that the nipples can match as closely as possible.

Then, under only local anesthesia, a tiny incision is made toward the base of the nipple.  The nipple is carefully raised from its tethered state while the dense bands/ducts are released.  The procedure is complete when the nipple is not tethered anymore.  A stitch is then carefully placed encircling the base of the nipple to hold it in a standing position (the stitch is removed in 10-14 days). A protective dressing is then placed overtop the nipple/areola.  That’s it.  10 minutes or less.  You even get to pick the music we’re listening to (unless it’s country, but typically even in these cases my arm can be twisted).

Post-operatively you may have some discomfort, but Tylenol or Motrin should be all you need.  You will likely have some changes in nipple sensation but this is temporary in the majority of cases.

Can you breastfeed after surgery?  Great question.  Typically with more severe types of inverted nipples, breastfeeding isn’t possible even before the surgery anyway.  There are anecdotal reports that the ducts can reform and breast feeding is possible after this procedure.  I counsel patients that this procedure is to improve the appearance of the nipple.  The procedure is not done to allow for breastfeeding, as I cannot quote success rates for this indication.  If you can currently breast feed, and are worried about losing this ability with surgery, it may be best to wait until you are done breastfeeding before undergoing the procedure.

If you have an inverted nipple (or actually, any concern about nipple appearance, including the opposite issue of large/overprojecting nipples needing reduction), I’m happy to see you for a consult and discuss how I can assist.