Inverted nipple surgery at Chester, The Grosvenor Hospital

What is inverted nipple surgery?

Inverted nipple surgery corrects a nipple that points inward, or lies flat, rather than protruding outward as usual.

What causes inverted nipples?

Inverted nipples happen when the milk ducts running from the breast tissue to the nipple are shortened, or the surrounding tissue is too tight, pulling the nipple inward rather than letting it sit outward.

The condition is common, thought to affect somewhere between 10 and 20% of people, and can involve one or both nipples in either men or women. It might have been there since birth, or it can arise afterwards because of breastfeeding, hormonal shifts, or scarring left behind by earlier surgery or an injury.

If a nipple that's always pointed outward suddenly turns inward, it's worth seeing a doctor, since this can occasionally signal an underlying issue, such as breast cancer, that needs ruling out.

What are the benefits of inverted nipple surgery?

Surgery restores the nipple's natural outward shape, which can help with self-confidence and body image for anyone who finds the appearance distressing or a source of embarrassment.

Depending on how severe the inversion is, some techniques can also preserve the ability to breastfeed in future.

Are there different grades or approaches?

Inverted nipples are usually described using three grades:

• grade 1, where the nipple can be drawn out, whether by hand or through stimulation, and stays out for a while before retracting again; breastfeeding is usually still possible
• grade 2, where the nipple can be drawn out but retracts as soon as it’s released; breastfeeding may be more difficult
• grade 3, where the nipple can't be drawn out at all, even manually

Milder cases are sometimes managed with a non-surgical suction device, worn over the nipple for a period, rather than surgery.

Where surgery is needed, milder cases can sometimes be treated by gently stretching the ducts rather than cutting them, helping to preserve breastfeeding potential. More significant inversion may need the ducts divided completely, which usually means breastfeeding won't be possible afterwards. Your surgeon will discuss which approach suits your situation at your consultation.

What happens before inverted nipple surgery?

You'll usually have a consultation first, where your surgeon examines the size, shape and symmetry of your nipples, discusses what you're hoping to achieve, including whether keeping your ability to breastfeed matters to you, and may take medical photographs to inform how the procedure is planned.

What happens during inverted nipple surgery?

1. Local anaesthetic is injected to numb the nipple; this may sting briefly, but the procedure itself is then painless.
2. A small cut is made either at the nipple’s base or around the edge of the areola.
3. The tight ducts or tissue fibres pulling the nipple inward are released, either stretched gently or, in more severe cases, divided completely.
4. Stitches, sometimes placed internally, hold the nipple in its new, outward-facing position while it heals.
5. The incision is closed, usually with dissolvable stitches.

The procedure usually takes around 15 to 30 minutes per side.

What does recovery look like?

A protective dressing is usually worn over the area for the first couple of weeks. Some surgeons also recommend a supportive dressing under your bra for up to 6 weeks, to protect the nipple while it heals.

Many people are back at work and managing light activities within several days to a week, though it's sensible to avoid strenuous activity and sport for around 6 weeks while healing completes. Mild discomfort, bruising or swelling in the area is common during the first couple of weeks.

Results are generally long-lasting, though any scarring can take several months to fully fade.

What are the risks and complications?

Possible risks of inverted nipple surgery include:

• an unexpected reaction to the local anaesthetic
• bleeding or infection at the site
• a change in nipple sensation, becoming more or less sensitive, though for most people it stays the same
• loss of the ability to breastfeed, particularly where more severe inversion has needed the milk ducts divided completely
• the nipple becoming inverted again over time, sometimes needing a further procedure