Centres of Excellence -> Plastic, reconstructive and aesthetic surgery -> Correction of inverted nipples

Correction of inverted nipples

Inverted nipples are a relatively common physiological variation and are characterized by nipples that appear to be inverted rather than protruding. This condition can be congenital or acquired due to factors such as pregnancy, breastfeeding or scarring. It is caused by variations in the connective tissue and muscle fibers surrounding the nipple.

Congenital inverted nipples develop during breast development and are generally harmless, often causing no discomfort or functional problems. However, they can present challenges for breastfeeding, as the infant may have difficulty latching onto the nipple.

Acquired ingrown nipples can be the result of scarring from surgery, infection or injury. Hormonal changes during pregnancy can also temporarily turn nipples.

While inverted nipples are usually benign, any sudden changes in nipple appearance, including inversion, should be evaluated by a healthcare professional, as they may signal an underlying medical condition such as breast cancer.

Inverted nipples can be categorized into three main types based on their degree of indentation:

  • Grade 1: Mild inversion, where the nipple can be easily pulled out and temporarily retains projection.
  • Grade 2: The nipple is more retracted and requires some effort to pull out. Tends to return to inversion after release.
  • Grade 3: Severe inversion, where the nipple is deeply retracted and difficult to pull out.

These categories help determine the appropriate treatment approach, whether non-surgical methods such as exercises or shields for milder cases or surgical techniques for more severe cases.

Should inverted nipples be corrected?

The decision to correct inverted nipples is personal and depends on individual preferences and possible functional problems. Although congenital inverted nipples are generally harmless, they can present challenges during breastfeeding. Acquired inverted nipples can be the result of scarring or hormonal changes. If the condition causes discomfort, self-consciousness or interferes with breastfeeding, surgical correction is an option. However, it is critical to consult with a healthcare professional to discuss the potential risks, benefits, and most appropriate course of action based on your specific situation.

Methods of correction of indented nipples?

  • Nipple exercises: non - surgical techniques include gently massaging and pulling on the nipples to encourage them to stick out.
  • Nipple shields: these devices can help pull out nipples and help with breastfeeding.
  • Piercing: in some cases, nipple piercing can encourage projection, although it is not a medical procedure and carries risks.
  • Surgical correction: surgical procedures release tissues causing inversion. Options include small incisions, stitches, or tissue grafting.
  • Nipple prosthesis: a small silicone device can be placed under clothing to give a better appearance.

Surgical methods of treating ingrown nipples??

  • Nipple release: this procedure involves making small incisions at the base of the nipple and releasing the clamp fibers that cause the inversion.
  • Suturing techniques: sutures are placed under the nipple to create projection. Different methods can be used such as bag sutures or internal sutures.
  • Tissue grafting: tissue from other parts of the body can be used to support and maintain the new projection of the nipple.
  • Local flap procedures: nearby tissues are reshaped to provide support and projection to the nipple

Correcting a inverted nipple can lead to possible complications such as infection, bleeding, scarring or changes in nipple sensation. In some cases, inversion may recur due to tissue healing patterns.

What does the preoperative process look like?

During the examination, the doctor will explain all the details of the surgery, advise you in choosing the type of operation and familiarize you with the postoperative protocol. You will also discuss with the doctor your medical history, medications you are taking that may need to be changed around the time of surgery, any drug allergies, and your habits such as smoking, which may also have an effect on the outcome of the surgery. You will be given a list of tests to be done before the surgery.

What to expect on the day of surgery?

On the day of surgery, it is important that you do not take food at least 6 hours before the agreed time of surgery and clear liquids at least two hours before. If you have an increased risk of developing deep vein thrombosis of the legs, we will ask you to visit the hospital the evening before the surgery to receive a medicine that will prevent the formation of clots in your legs during the surgery. After the surgery, you will stay in the hospital for some time until the anesthesiologist assesses that you are ready to be discharged, and if necessary, you may stay in the hospital until the next morning. Before you are discharged home, we will place special protectors on you to avoid pressure on the operated nipples with clothes or while sleeping.

After surgery

The first control is usually 2-3 days after the surgery. You can shower freely seven days after the surgery. You can expect to return to lighter physical activities and driving a car, depending on the type of procedure, within 1 week, while for more difficult physical activity you should wait 3-4 weeks. You should also pay attention to the care of the scar, which from the third week after the surgery needs to be massaged twice daily with a moisturizing cream. Nipple shields must be worn for 6 weeks after surgery.

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