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Inverted Nipple Repair
 
For many women, having inverted nipples can be distressing. Lying flat against the breast or actually pulling in from the breast surface, they can be a source of self-consciousness and breastfeeding problems.

Inversion of the nipple is caused by a short milk duct system running from the chest wall to the nipple. Thanks to various techniques in plastic surgery, however, women with inverted nipples no longer have to live with this condition; in fact, they have a choice of two types of procedures. Regardless of procedure chosen, inverted nipple repair can restore the nipple to a beautiful and natural, projecting appearance.

If you're considering inverted nipple repair, the following information will provide you with a good introduction to the procedure involved. For more detailed information about how this procedure may help you, we recommend that you consult a plastic surgeon who is board certified or has completed a residency program that includes instruction in this procedure.
Inverted Nipple Repair Photo Gallery
Inverted Nipple Repair Video Gallery
 
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What are the most common benefits of this surgery?
Surgical procedures to correct the inverted nipple can be divided into two types: those that leave the milk ducts intact and those that do not. In either case, the objective is to reshape the nipple and areola so that the nipple projects out from the breast, enhancing the appearance of the breast while preserving sensitivity of the nipple. The technique that leaves the milk ducts intact can also help preserve a woman’s ability to breastfeed.
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What will happen at the initial consultation?
During the initial consultation, you and your surgeon will discuss the changes that you hope to see in your appearance. He/she will explain the different options available to you, the procedure itself, and its risks and limitations. He/she will also explain the kind of anesthesia required, the surgical facility to be used, and related costs.

Your surgeon will begin with a complete medical history. He/she may also give you specific instructions preparing for surgery, including guidelines for eating and drinking, smoking, and taking or avoiding vitamins, supplements and medications.

Take this opportunity to ask all the questions you have about the surgery. Ask for, and follow up on, patient references. Learning everything you can about your options, risks and benefits is the key to making an informed decision. See Questions to ask your doctor below.
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How is inverted nipple correction surgery performed?
Techniques used today fall into two categories: those that preserve the milk ducts and those that do not.

Inverted nipple repair with partial preservation of milk ducts: Your doctor will administer a local anesthetic as well as a sedative to help you relax. An incision will be made just around the base of the nipple on the areola.

The nipple and areola tissue is lifted from (but still connected to) the breast and stitched into a new, projecting shape utilizing a “purse-string” style of suturing (stitches). Because of the circular shape of the scar around the nipple, scar contracture will actually increase rather than decrease nipple projection. Medicated gauze is then applied to the site.

Inverted nipple repair with detached milk ducts: This procedure is much more common and may be necessary in more difficult cases. Your doctor will apply local anesthetic, and you will be offered a sedative. An incision is made at the nipple base, and the shortened milk ducts are detached, allowing a natural-looking projection of the nipple. The incision is sutured closed, and medicated gauze is applied to the site.
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How long does the surgery take?
Inverted nipple repair takes one to two hours, depending on the technique used and the anatomy of the patient.
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Will I have to stay in the hospital?
Probably not. Most breast surgeries are performed as outpatient procedures, in a surgical center. Most patients are able to return home within a few hours of the surgery.
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How much pain is there?
Your nipples will be sore after the procedure, but this soreness will probably subside within a few days. Most patients report that this discomfort is easily controlled by medication.
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What can I expect after surgery?
Your nipples will be covered with medicated gauze. Under the gauze will be tiny, stitched incisions. You may feel a little groggy, which is a side effect of surgery and your body’s efforts to heal. Because of the localized nature of the procedure, this grogginess should subside in a day or so. Most likely, you will be allowed to leave the hospital within a few hours after the surgery, but you should have someone else drive you home. You will probably be allowed to shower the next day.
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What is the recovery period like?
Most often, swelling is mild to moderate, peaks two or three days after the procedure, and then disappears rapidly over the following three weeks. Most patients report little or no bruising. Sutures (stitches) are usually removed about four days after surgery. You will probably be able to return to work within the 24 – 48 hours, unless your work involves strenuous activity.
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What is the long-term outcome like for most people?
Both techniques: The new nipple projection is permanent. Sensation is almost always unchanged. Because the incisions are at the nipple only, scarring is scarcely visible.

Parachute-flap technique(preserving ducts): Because some of the milk duct system is still attached to the nipple, breastfeeding is likely.

Detached duct technique: You will not be able to breast feed.
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Ideal Candidate:
In general, the best candidates for asymmetrical breast correction are:
  • 18 years of age or older
  • Not currently pregnant or nursing
  • In good physical health
  • Psychologically stable
  • Wanting to improve their appearance
  • Realistic in their expectations
  • Having this surgery for the first time
The above is only a partial list of the criteria that your surgeon will consider in determining whether or not this procedure is appropriate for you. Be sure to ask your surgeon if he / she considers you an ideal candidate for inverted nipple repair.
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Other important information
Women who want to correct inverted nipples in order to breastfeed more easily should know that they have other options in addition to plastic surgery. First of all, contrary to popular belief, breastfeeding does not involve the nipple so much as the breast itself, and a hungry infant can achieve quite a vacuum, pulling a moderately recessed nipple out into his/her mouth. Many women interested in breastfeeding are concerned that their nipples are inverted, whereas in reality their nipples will serve quite adequately--when the time comes--without medical assistance. (The true inverted nipple is reportedly rare. It is characterized by a tendency to retract when the area around the nipple is squeezed.) A flat or even slightly recessed nipple will not necessarily prevent successful breastfeeding.
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Risks and Limitations
All operations carry some risk and the possibility of complications can include (but are not limited to) infection, unsatisfactory results, excessive bleeding, adverse reaction to anesthesia, and the need for second or sometimes third procedures. The ability to breastfeed cannot be guaranteed after any surgery to correct inverted nipples.
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Choosing a doctor:
It is critical to select a physician who is adequately trained and experienced in inverted nipple procedures. We strongly recommend that you consider choosing a surgeon who is board certified by the American Board of Medical Specialties. See our Physician Locator feature to find a surgeon in your area, including detailed profile information for many of the listed doctors. Also read How to Select a Plastic Surgeon for a more detailed discussion on choosing the right doctor.
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Questions to ask your doctor
  1. Are the desired results I described realistic?
  2. Where is the surgery performed? How long will the procedure take?
  3. How much will my appearance/nipple protraction improve?
  4. Is it realistic to expect to be able to breastfeed in my particular case?
  5. Would another procedure, surgical or non-surgical, work better for me, given my objectives?
  6. Are there other procedures that I should consider to enhance the effects of this particular procedure?
  7. What kind of anesthesia is used?
  8. What is your experience in performing this procedure? (How long has he/she performed this procedure, and how many has he/she performed in the past year?)
  9. What percentage of patients have had significant complications? (The physician should disclose this information to you.)
  10. Will you repeat or correct the procedure if it does not meet agreed-upon goals? And if the procedure must be repeated / corrected, will I be charged again? (The physician should provide you with his/her policy on this issue.)
  11. May I see “before and after” photos of recent patients?
  12. May I have the names and contact information for several recent inverted nipple repair patients? (Follow up and get firsthand information on the procedure and surgeon.)
  13. Could I observe the exact procedure I am considering before I decide to have the surgery? (Either on videotape or in person.)
  14. What should I expect post-operatively in terms of soreness, what to watch for, medication, bathing/showering/swimming, and level of activity?
  15. Who will be assisting during the surgery? What are their qualifications? (Does the plastic surgeon perform the entire surgery?)
  16. Have you ever had your malpractice insurance coverage denied, revoked, or suspended?
  17. Do you offer patient financing?
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Be sure to
  • Tell your doctor about any allergies you have (to foods, drugs, environmental elements).
  • Tell your doctor about all medications, herbal supplements or natural supplements you are taking (both prescription and non-prescription), including such natural remedies as Echinacea and St. John’s Wort.
  • Be sure to tell your doctor if you smoke. Smoking can lead to complications and poor healing.
  • Carefully follow any instructions your surgeon gives you regarding eating and drinking.
  • Avoid aspirin and aspirin-containing medicines for two weeks prior to surgery.
  • Arrange for someone to drive you home after surgery and help you for a few days afterward, if needed.
The information on this web site is intended only as an introduction to this procedure and should not be used to determine whether you will have the procedure performed nor as a guarantee of the result. The best method of determining your options is to consult qualified surgeons who are able to answer specific questions related to your situation.
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How do I finance this procedure?
Did you know that 29% of all Americans have considered having an elective procedure? Of those, 60% would schedule a procedure immediately if financing was available. With iEnchance's patient financing options, money no longer has to be the barrier between you and your new image. By filling out our on-line application you can qualify for a loan in as little as 30 seconds.
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Related Articles
Please review the following articles for more information on this procedure.
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Facts:

*Top 5 Surgical Cosmetic Procedures in 2008:

1. Breast Augmentation: 356,000
2. Liposuction: 341,000
3. Blepharoplasty: 195,000
4. Rhinoplasty: 152,000
5. Abdominoplasty: 147,000

*Top 5 Non-Surgical Cosmetic Procedures in 2008:

1. Botox: 2,464,000
2. Laser Hair Removal: 1,281,000
3. Juvederm/Restylane: 1,263,000
4. Chemical Peel: 592,000
5. Laser Skin Resurfacing: 571,000

* Data collected from the American Society of Plastic Surgeons (ASPS)
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