Inverted Nipple Correction

Inverted Nipple - Causes and Correction

23rd February 2011

Inverted Nipple Correction

Mr Adrian Richards, Leading Plastic Surgeon of Aurora Clinics provides you with valuable information on the causes of Inverted Nipples in men and women, and how you can correct them with surgery under local anaesthetic. For more information or should you wish to book a FREE Consultation with our specialist plastic surgeon, please call us on 01844 214362.

Transcript

Inverted Nipples – Causes and Correction

Hello. I’m Adrian Richards and I’m a plastic surgeon. Today I’m going to be talking a little bit about inverted nipple correction. Now, this is something I’m very interested in and quite passionate about, because I’ve seen many patients with inverted nipples and it really can affect people. They don’t like them. It makes it difficult wearing clothes. Often the inversion is difficult to conceal through thin clothing. And it makes intimate relations difficult for some people. So inverted nipples are common, and they cause distress, and the most important thing is that they’re easily corrected under local anaesthetic.

There are three grades of inverted nipple. Grade one are nipples which are inverted but do evert on stimuli and stay everted for a period of time. Grade two inverted nipples are inverted, do evert, but invert spontaneously and don’t stay everted. Grade three are inverted and never become everted.

Now, different procedure really for each type of inversion. Grade one, these are the ones that come out and stay out for a period of time, are often best treated by a suction device known as a Niplette, which is a suction device used normally at night, which tends to slightly stretch the milk ducts which are causing the inversion and often is very effective for a grade one inversion. So I would normally suggest that anyone with grade one inversions certainly tries the Niplette suction device.

Why do people get inverted nipples? It’s a shortening of the milk ducts. The milk ducts travel from the milk glands to the nipple, and in some people, as the breast grows, the ducts do not grow sufficiently and act as a tether pulling the nipple in. So the nipple wants to come out, can’t come out because it’s tethered.

So, for grade two nipples, there are different approaches. Again, operation is performed under local anaesthetic. It typically takes 10 minutes per nipple. And the options are either to stretch the ducts, the milk ducts, but keeping them in tact or divide them.

So in grade three, these are nipples which are inverted and never come out, the only real option is to divide the milk ducts, because the milk ducts are so strong and tethered you won’t be able to tease them out to get an adequate increase in length. So grade three, division of the ducts. The only problem with division of the ducts is you won’t be able to breastfeed after the ducts have been divided.

Grade two, you need to make a decision about how important breastfeeding is for you. If breastfeeding isn’t crucially important, the surgeon divides the ducts. That’s the most sure way of correcting the nipple inversion. But if breastfeeding is very important to you, you need to discuss possible operations to lengthen the duct by teasing the ducts out.

So grade one, think of the Niplette. Grade two, options are either duct teasing out, duct lengthening, or duct division. Grade three, really duct division.

How is the surgery performed? It’s under local anaesthetic. I do it as a walk in/walk out procedure, which typically takes about 30 minutes in total. The nipple area is cleaned, local anaesthetic infiltrated into it, and after that, it really shouldn’t hurt at all. And a very small incision is made just at the base of the nipple. The ducts are either divided and teased out through a very small incision, and then an absorbable internal stitch is used to hold the base of the nipple together to stop the inversion. And then a light dressing of brown tape is put on, which is changed after a week. And thereafter you don’t need any more dressings.

So it’s a very successful operation, minimal scarring, really quite minimal down time. If the ducts are divided, the risk of recurrence of the inversion is really very low. And nipple sensation, because nipple sensation comes via the skin of the nipple, which does not affect the nipple sensation, and over 90% of cases, it’s not affected at all.

So again, if you have got inverted nipples, very common, one in 10% of the population do have some inversion. If you suddenly develop inversion when you haven’t had inversion before, you need to go to a GP or breast specialist just to make sure there’s no underlying abnormality of the breast, because cysts or occasionally breast cancers can cause sudden inversion of the nipples. So that needs to be checked out.

If it’s long-standing inversion, ever since your breast have developed, there is a technique to correct it under local anaesthetic, but you need to think carefully about breastfeeding and have a full discussion with your surgeon about the best approach for you. I have talked to patients who have had the inverted nipple corrections and other surgeons about their approach to inverted nipples in our podcast if you would like to listen to those. If you have any questions about inverted nipples and how they’re best treated, please feel free to either e-mail us at Aurora Clinics or ring us, any form of contact, and we’re more than happy to answer your questions. I hope that’s answered some of your queries. Thank you for watching.