Frequently Asked Questions
WHAT ARE INVERTED NIPPLES? ARE MY NIPPLES “NORMAL”?
Breasts come in all shapes and sizes and so do nipples. There are different types and significant variations in the appearance of areolas for every woman. Up to 90% of women have common nipples - known as those that stand out at rest and become erect when cold, touched, and aroused. Even between the common majority, there are differences in shape and positioning. Beyond asymmetry, some face front while others point sideways.
The remaining 10% of women have flat or inverted nipples. You can even have a mismatched pair, such as one nipple higher than the other, or only one is inverted or flat.
Knowing this may bring relief if you are concerned that your nipples are not "normal”. Even if you feel weird about your nipples, know that you are among a considerable percentage of people. But if you sense your nipples are signaling potential complications, they are worth investigating. And you should see a Breast Care Specialist.
WHAT CAUSES INVERTED NIPPLES?
Inverted nipples can occur naturally and represent no harm to your health. Many patients are just born with the condition. But inverted nipples can also be caused by trauma, fibrocystic breast disease, infection, and breast cancer. So, if a previously “normal nipple” begins a turn-in without reason, it can be a signal to investigate issues beneath. And you should report it to your doctor at the earliest opportunity.
ARE INVERTED NIPPLES RELATED TO CANCER?
An inverted nipple in itself doesn't mean you have breast cancer. But nipple retraction can be a symptom of common types of breast cancer, such as carcinoma. Breast self-exam, or regularly examining your breasts on your own, can be an important way to find out about the disease early on. That includes also checking on your nipples regularly. If one or both of your nipples suddenly become inverted, you should investigate it with your doctor and rule out cancer as soon as possible.
WHAT TO EXPECT FROM INVERTED NIPPLE CORRECTION SURGERY?
Inverted nipple repair is generally an hour-long, outpatient procedure that typically involves the use of a local anesthetic. From a starting point, you should know that there are two different types of surgeries: surgery that preserves the milk ducts and surgery that doesn’t.
● Surgery with partial preservation of milk ducts
In this form of surgery, the doctor will perform a parachute flap technique and there should be no change in how the nipple feels afterward. Having numbed your breast, the surgeon makes an incision around the base of the nipple. While still attached, your nipple and areola are picked up from the breast and sutured back pointing out. Finally, the surgical area is carefully stitched and covered with bandages.
● Surgery with detached milk ducts
This is the most common method and you won’t be able to breastfeed afterward, because your milk ducts will be completely cut off. In this technique, a cut is made in the base of the nipple, and milk the ducts are cut to release the areola from the breast tissue that will be later pulled out. Finally, the surgical area is carefully stitched and covered with bandages.
DO I NEED INVERTED NIPPLE SURGERY?
In all cases, this type of correction procedure is not a medical necessity. Before deciding to undergo surgery, you’ll need to look into the ‘grade’ of inversion of your nipples. Overall, it can be categorized into 3 grades:
● Inversion grade 1
If by squeezing the areola, your nipple easily bumps out and holds its form, not instantly returning inwards, you might have grade 1 inversion nipples. This type of inversion usually doesn't cause any problems for breastfeeding and the nipple can be easily pushed out by hand. You may be discontent with how it looks, but it is not problematic in terms of swelling tissue or mammary duct ectasia. And does not require inverted nipple correction surgery.
● Inversion grade 2
In this scenario, after being pulled out and released the nipple quickly retracts inwards. If that is your case, you can experience problems breastfeeding and have more chances of swelling tissue and mammary duct ectasia.
● Inversion grade 3
With this grade, there's no change seen after the nipple is pulled. It remains inverted despite any effort. It is a more serious stage of nipple inversion that usually requires medical intervention. The risk of rashes, sore nipples, and recurrent mastitis can make breastfeeding nearly impossible. If that is your case, inverted nipple correction surgery is often recommended.
WILL I BE ABLE TO BREASTFEED AFTER NIPPLE SURGERY?
There’s no certainty to this concern. It depends on each specific case. Your surgeon will attempt to conserve as many milk ducts as possible, but everything comes down to your particular inversion and the technique that can be used. If you intend to breastfeed and have a less severe case of inversion, it is recommended that you perform the surgery after you have finished breastfeeding. But, if your grade of inversion prevents you from breastfeeding or may bring other complications, it’s recommended to evaluate with your surgeon which route makes breastfeeding more possible for you.
HOW IS THE RECOVERY AFTER THE INVERTED NIPPLE SURGERY?
Since only a local anesthetic is required, you are likely able to go home on the same day. You’ll probably experience some mild pain or bruising following surgery that can be treated with mild painkillers. As with any surgical procedure, you should avoid any strenuous activity, including heavy exercise, for at least 1 week following the surgery. Any form of breast compression should be avoided, like tight bras or tops. Overall healing and recovery time typically takes 4 weeks. But your doctor will provide you with detailed instructions on your particular surgery and recovery process.
WHERE CAN I GET INVERTED NIPPLE SURGERY NEAR ME?
Having inverted nipples can often negatively impact your body image. In StudioMD, we understand how feeling happy and confident with your breasts can impact your daily life and your self-esteem. Our facilities offer cutting-edge surgical and non-surgical breast procedures, providing the highest level of personalized patient care.
At StudioMD, you’ll be seen by Dr. Sharon Giese, who is a breast specialist, completing a fellowship in breast and aesthetic surgery at Georgetown University. As a leading authority on plastic surgery, Dr. Giese has been featured in many broadcasts, including CBS’ The Early Show, The Dr. Oz Show, FOX, ABC’s Good Morning America, and NBC's Today Show. Dr. Sharon Giese and StudioMD staff will be happy to schedule a consultation about your nipple inversion surgery.