An inverted nipple is one that is drawn inward into the breast; the method of correction depends on the degree of inversion.
An inverted nipple is one that sits below the surface of the areola, drawn inward. It occurs when the milk ducts beneath the nipple are short or fibrous tissue pulls the nipple in; it is usually congenital but can also develop after breastfeeding, inflammation or surgery. A flat nipple, which is not inverted but has almost no projection, is treated in the same category.
An inverted nipple is not only a matter of appearance. Secretions collect in the inverted area, so odor and inflammation tend to recur, and in some cases the nipple does not come out for breastfeeding, making it difficult or leading to mastitis. Correction aims to resolve these hygiene and functional problems as well.
The method of correction depends on the degree of inversion. We grade it by checking whether the nipple comes out easily when pulled, comes out but retracts again, or does not come out at all, and decide whether to preserve the milk ducts according to that grade and your breastfeeding plans. At Atelier Plastic Surgery we discuss duct preservation first and then choose the method, and Dr. Go personally handles everything from consultation to surgery and follow-up.
Only the fibrous tissue pulling the nipple inward is released from beneath the nipple, and the milk ducts are preserved. Through a small incision at the base of the nipple, the fibrous bands are divided, and sutures are added to support the nipple from below so that it does not retract.
When short milk ducts pull the nipple strongly inward, some of the ducts are divided to bring the nipple fully out. It corrects more strongly and tends to recur less, but it may affect breastfeeding, so it is chosen when there are no plans to breastfeed.
After the nipple is brought out, the space beneath it is empty and the nipple may retract; to prevent this, surrounding dermal tissue is shaped into a flap to fill and support the area beneath the nipple. It is combined with either method, regardless of duct preservation, to reduce recurrence.
When the nipple is out but has almost no projection, the base of the nipple is narrowed to create projection. Sutures are added around the nipple, or dermal tissue supports it from below, to build the shape.
Surgical designs and results are drawings based on photos; results vary by individual.
These may vary depending on your condition; we will give you precise details at your consultation.
The grade differs depending on whether the nipple comes out easily and stays out when pulled, comes out but retracts again, or does not come out at all. The grade determines whether releasing the fibrous tissue alone is enough or the milk ducts also need to be addressed.
Preserving the milk ducts keeps the possibility of breastfeeding but has a relatively higher chance of recurrence; dividing them corrects more strongly but affects breastfeeding. After checking your plans for childbirth and breastfeeding, we decide together which to prioritize.
If the space beneath the nipple is left empty after it is brought out, it may invert again over time. A dermal flap or supporting sutures hold the base of the nipple so that the shape is maintained.
When inflammation or discharge recurs in the inverted area, we assess the condition before surgery and treat it first if needed. Operating while inflammation is present increases the chance of infection and wound problems.
If performed under local anesthesia, you can go home right away. A protective device or dressing is applied so that the nipple is not pressed, and you avoid pressure and friction that day.
There may be swelling, bruising and a stinging feeling at the suture site. Keep the protective device on and take the prescribed medication.
At your visit we check the projection of the nipple, its blood supply and the wound. Showering becomes possible depending on the state of the wound.
Stitches are removed. The protective device may be worn for several more weeks, depending on your condition, so that the nipple is not pressed.
Swelling subsides and the projection of the nipple begins to stabilize. There may be firmness or changes in sensation, which gradually recover.
Shape and sensation settle. We watch for recurrence over this period and, if needed, discuss further correction.
After inverted nipple correction, bleeding, infection, swelling and bruising, and separation of the suture line may occur. Because the tissue beneath the nipple is dissected, sensation may become dull or oversensitive; this mostly recovers, but in some cases it can persist for a long time. Methods that divide the milk ducts may make breastfeeding difficult, and duct-preserving methods can also affect breastfeeding depending on the degree. The nipple may invert again after correction; the chance is higher when the inversion was severe and with duct-preserving correction, and further correction may be needed. Asymmetry of projection between the two sides, distortion of the nipple shape, scarring along the suture line and, rarely, damage to nipple tissue from reduced blood supply may occur. Results vary by individual, and all of this is explained fully at consultation.
The content on this page is general medical information provided in accordance with the Medical Service Act. The results of surgery and treatments and the recovery period may vary by individual. All surgeries and treatments carry a risk of side effects, so please decide after a thorough consultation with a specialist.
Nipple deformity correction with a method for each shape
Learn more Related Nipple reductionNipple reduction that looks at length and width separately
Learn more Related Areola reductionAreola reduction that sets the diameter to fit the size of the breast
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