Some people have inverted nipples. This is a condition where one or both nipples face inside the breast instead of protruding out. This can occur for a variety of reasons such as the breast ducts being not long enough, the tissues being too tight or there being too much connective tissue in the breast. Women with inverted nipples may have difficulty breastfeeding.
Sometimes the condition can resolve itself over time; however, patients can opt for surgery if it doesn't.
The surgical procedure requires the breast tissue to be cut open and the nipple pushed outwards. Depending on the grade of inversion and on whether the woman is planning on breastfeeding, surgeons may use different techniques.
Grade 1 inversion is characterized by the ability to squeeze out the nipple by applying gentle pressure and/or if the nipple moves outwards when stimulated.
Grade 2 inversions may be slightly more challenging to push out, and will retract once the pressure causing the outward motion is removed.
Grade 3 inversion is when the nipple cannot be pulled out at all.
There are two main surgical techniques used. The first preserves while the second perforates the galactophores (milk ducts). Usually, the first option is preferred for women who wish to breastfeed in the future. It works best for milder inversions as it cuts the circumferential tissues and pulls out the nipple tissue.
However, some patients may undergo reinversion surgery after a failed first attempt. In these cases, surgeons need to remove the galactophores, which ceases the ability to breastfeed. During this technique, surgeons make incisions around the nipple. They remove the galactophorous ducts, reposition the nipple and stitch it in place.
A nipple inversion surgery could require either general or local anesthetic.
It is usually a quick, outpatient procedure taking about 20-30 minutes. Sutures stay on for 14 days before removal. Patients will have to avoid strenuous activity for the next two weeks, including swimming and baths.
