Inverted Nipple Surgery

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.

Procedure: 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.

Length of the procedure: 1 to 2 hours

Recovery: Most of the surgeries performed as outpatient procedures. 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. 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 to 48 hours, unless your work involves strenuous activity.

Results: 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.

Risks and complications: 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.