An inverted nipple is a nipple that doesn't "stick out" or point outward. Instead, the nipple retracts back into the breast. This fairly common condition can affect both women and men, and approximately 10-20 percent of women have inverted nipples from birth.
What Are the Causes of Inverted Nipples?
You can either be born with inverted nipples or acquire them later in life. The condition doesn't always affect both nipples because you can have one nipple that's inverted while the other protrudes.
True inverted nipples don't stick out from stimulation or coldness. Nipples become inverted when the ligaments in the milk duct that connect the nipple to the chest wall are too short to allow the nipples to protract. It's also possible to be born with nipples that are normally inverted but can protrude with stimulation or exposure to cold temperatures.
If your nipples became inverted later in life, the breast skin may have become looser around the nipples, making them look like they're inverted. Nipple inversion can be caused by pregnancy, breastfeeding, breast cancer, Paget's disease, major weight changes, surgery, physical trauma, tuberculosis or Gynecomastia. Sudden changes in your nipples should be checked by the doctor.
Are Your Nipples Inverted?
The severity of your nipple inversion can be determined by using a three-level graded scale. The scale increases based on how much your nipples retract and how easily they can be pulled out.
Grade I nipple inversion describes nipples that can be pulled out fairly easily, either by applying pressure or something cold to coax out the nipple. Women with Grade I nipples don't usually have issues breastfeeding.
If you have Grade II inverted nipples, you can still coax out your nipples, but you may notice they don't stay protracted. You may be able to breastfeed with Grade II inverted nipples, but you might find it painful or impossible.
Grade III nipple inversion refers to nipples that never protrude, regardless of whether pressure is applied. The milk ducts are scarred, and it's impossible to breastfeed. If you have Grade III inverted nipples, you are also more susceptible to infection and irritation.
If you're unsure about the severity of your nipple inversion, try out the "pinch test" to determine whether you have inverted nipples or not.
In minor cases of nipple inversion you can use manual stimulation to remedy the issue, but in cases where the issue is more severe, surgical correction could be required.
San Antonio Plastic Surgery Options for Inverted Nipple Repair Surgery
There are many types of inverted nipple repair surgery: some preserve the milk ducts, and the other one does not. In all cases you'll be in and out of surgery within a few hours, and both surgeries begin with your surgeon administering a local anesthetic and sedation.
If you're aiming to preserve your milk ducts, your surgeon will first make an incision around the nipple base and areola. After that, the nipple tissue is gently lifted and formed into a new shape using small z-plasty flaps that will then cause the nipple to protract.
If you have more severe nipple inversion or breastfeeding is less of a concern, surgery via milk duct detachment will be your best option. Your surgeon will make an incision at the nipple base and detach your milk ducts, which will make the nipple protract. Afterward, your surgeon will suture the incision and finish by applying a dressing.
If you have inverted nipples and want them corrected, be sure to book a consultation with Dr. Matt Bindewald, a San Antonio plastic surgeon known throughout South Texas for his expertise in breast reconstruction.