Inverted Nipple Correction

• Abnormalities of the nipple or tissue underlying it are very common and relatively straight forward to treat
• The most common condition is nipple inversion
• In this condition the nipple instead of protruding is held inside the breast
• This is caused by shortening of the ducts which come from the glandular tissue within the breast to emerge on the nipple
• Nipple inversion can cause significant embarrassment and can occur on one or both sides
• Some patients find it difficult wearing clothes particularly thin tops or swimwear as the inversion can be visible

Nipple inversion is classified into the following three groups:

Grade 1

• The nipple can be everted and look normal
• After a variable period of time if reverts to its inverted position

Grade 2

• The nipple can be everted and look normal if drawn out
• However it immediately inverts when released
• Some people with Grade 1 and 2 nipple inversion find the Nipplette device useful
• This works by suction and gently pulls the nipple out to an inverted position
• If suction is applied regularly the tight ducts leading to the nipple stretch allowing it to sit in a normal everted position
• Generally it is best to try the Nipplette first as if offers a simple low cost solution
• For some people this solution does not work effectively and the inversion needs to be corrected with an operation

Grade 3

• These nipples are so tethered to the underlying breast tissue that they can not be
  everted
• Correction of inverted nipples with surgery is surprisingly quick
  and simple
• The procedure is performed under local anaesthetic and takes approximately 15 minutes per side
• There is some mild discomfort associated with the injection of anaesthetic which last for about 10 seconds- after this the procedure is painless
• The discomfort from the injection can be minimised by the application of an anaesthetic cream before the operation which numbs the area
  
  

• In the operation a small incision is made in the lower outer border of the nipple
• Depending on the grade of inversion the ducts leading to the nipple are then either gently stretched or divided
• If the ducts are stretched they remain intact and breast feeding is usually possible following the operation
• Once released the nipple is held in an everted position with an absorbable stitch
• This is placed internally and is naturally melted away by the body following the operation
• Following the procedure most people experience mild discomfort with most returning to work within 1-2 days
• The dressings are removed 5-7 days following the procedure and patients are encouraged to wear a soft padded bra for a further 2 weeks
• Once corrected the nipples are very unlikely to become inverted again and can be treated normally

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