What Are Inverted Nipples?
Inverted nipples are also called flat nipples or turned-in nipples. It’s simply when the nipples don’t properly stick out and become erect. They’re blended into the surrounding areola (pigmented skin).
The nipples are normally attached to the lactiferous ducts (milk ducts) to allow for breastfeeding. Flat nipples develop when the lactiferous ducts are too short. They pull the nipples inward.
Nipple inversion can affect one or both breasts. It can affect both men and women, however, women are more likely to be annoyed by them.
In themselves, flat nipples are not a medical concern unless they’ve developed suddenly, within a short period of adult life. Otherwise, if you’ve had them since puberty, or they developed over a long time, then you don’t have to worry.
Some of the problems caused by flat nipples include:
- Cosmetic concerns
- Inability to breastfeed
- Nipple irritation and inflammation
What Are The Grades of Inverted Nipples?
There are several grades of severity that plastic surgeons use to classify nipple inversion:
Inverted Nipple Grading System
- Grade 1: The nipples can be brought out easily with manual manipulation and they stay out
- Grade 2: The nipples can be brought out less easily with manual manipulation and they tend to retract again quickly. There’s moderate milk duct retraction and fibrosis.
- Grade 3: The nipples almost cannot be brought out with manual manipulation. There’s severe milk duct retraction and fibrosis.
Nipple inversion is also not always permanent. Some women have flat nipples only occasionally, and they stick out at some times on their own.
In a minority of women, flat nipples might completely resolve over a long period of time, even without surgery. Always try a Non-Surgical solution like the Avent Niplette device before surgery.
Why Patients Might Consider Inverted Nipple Surgery
Nipple inversion corrective surgery may be considered by patients for a number of different reasons, including:
- A more cosmetically appealing nipple-areola complex
- No more irritation and inflammation related to flat nipples
- Improved breast feeling abilities (if you get breastfeeding-preserving surgery)
- One-day procedure – no need to sleep at the hospital
- Can be done with local anesthesia – you don’t need to be put to sleep
What Is Inverted Nipple Correction Surgery?
Surgery to fix inverted nipples is called “inverted nipple correction surgery”. It’s a cosmetic procedure to bring out the nipples and make them protrude.
The goal of inverted nipple correction is to release the nipple from the retracted milk ducts, allowing it to come outward.
The main challenge when it comes to inversion nipple surgery is preserving breastfeeding after the procedure. If you still plan to have children in the future, you should discuss this with Dr. Hunt. If possible, Dr. Hunt will perform a lactiferous duct-sparing procedure – a technique to preserve the milk ducts and future breastfeeding.
This is usually possible in grade 1 nipple inversion, but much less possible in grades 2 and 3. In moderate and severe nipple conversion, it’s not possible to pull the nipple out without cutting the retracted milk ducts.
What Are The Types of Inverted Nipple Correction Surgery?
Inverted nipple correction is classified based on whether or not the milk ducts are cut, and hence whether breastfeeding abilities are preserved or not.
- Milk Duct Sparing Surgery
- Milk Duct Damaging Surgery
1. Milk duct-sparing flat nipple correction surgery
This type of inverted nipple correction surgery is for women with mild flat nipples who want to preserve their ability to breastfeed.
In lactiferous duct-sparing flat nipple surgery, the milk ducts are not cut. They are rather stretched so that the nipples can protrude.
Dr. Hunt starts with a micro-incision at the lower border of your areola (the pigmented skin around the nipple). He then releases any fibrous tissue pulling on the nipple and stretches the milk ducts.
The milk ducts remain attached to the nipple, so you should still be able to breastfeed. By stretching the ducts, the nipples are brought out and will become protruding.
To maintain the nipple in a protruding position, Dr Hunt will perform one or more surgical techniques, usually involving dermal flap technique and vertical suturing. This means that Dr. Hunt cuts the skin around the nipple and tightens it with sutures so that the nipple does not go back inside.
After the procedure, the areola skin is closed with very thin suture lines.
2. Milk duct-damaging flat nipple correction surgery
This inverted nipple correction technique is more commonly used in grade 2 and 3 nipple inversion.
Since this nonprojecting nipple correction procedure involves detaching the nipple from the retracted milk ducts, you will not be able to breastfeed after the surgery.
The procedure starts with a micro-incision at the bottom of the areola. Dr. Hunt will cut the milk ducts and fibrous tissue pulling the nipple. Once the nipple is free, he will bring it out and fix it in a protruding position using specialized suturing techniques (vertical and horizontal suturing).
Once the procedure is done, the areolar skin is closed with fine suture lines.
Both flat nipple correction techniques take around 1 hour to perform and are done with local anesthesia. Or general anaesthetic if preferred by the patient.
Recovery After Inverted Nipple Correction Surgery
You can expect to experience any or all of the following symptoms when recovering from nonprojecting nipple correction:
- Pain around the nipples
- Mild bleeding or spotting
- Swelling around the nipples
- Bruising at the bottom of the nipples and breast
- Numbness and tingling in the nipples
These flat nipple surgery side effects are normal and usually not a cause of concern. If you develop fever, major swelling, increasing pain, or see pus, then contact our clinic as soon as possible.
Here are some aftercare tips to help you take care of your breasts after flat nipple surgery:
Inverted Nipple Correction Surgery Aftercare
- Keep the surgical dressing for 4-6 days and change it daily
- If non-resorbable sutures were used, you should come back in 5-7 days to have them taken out.
- If resorbable sutures were used, they should disappear on their own within a few weeks
- You can apply ice packs to reduce swelling and pain
- Take your painkillers as needed – there’s no need to feel pain.
- Sleep on your back for the first 1-2 weeks after the surgery to avoid breast trauma
- Consider asking Dr Hunt’s team for scar reducing treatment to use on your wounds
Real Patient Results for Inverted Nipple Correction Surgery
The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors including the individual’s genetics, diet and exercise.
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Cosmetic Breast Surgery Guide
The ultimate Cosmetic Breast Surgery Guide has been created by Dr Hunt and his team as a useful tool to help you plan and consider this procedure.
Throughout the guide, we will discuss the ins and outs of different types of Breast Surgery, from what makes an ideal candidate, to pre-surgery planning answers to the most frequently asked questions received from real-life patients.
Inverted Nipple Correction Surgery Costs Sydney – How much does inverted nipple correction surgery cost in Sydney NSW? Prices & Fees
Determining the cost of flat nipple surgery in Australia is a little complicated. There’s a lot of things to consider when calculating the price of an inverted nipple procedure.
Where are you getting the surgery? What kind of anesthesia? Are you combining it with other cosmetic breast procedures? Which grade of nipple inversion do you have?
All of this comes into calculating the costs of nonprojecting nipple correction. Once you come in for your first consultation, Dr. Hunt will give you a fair estimate of how much you’ll have to pay.
Is inverted nipple correction surgery covered by Medicare or private health insurance?
Medicare and insurance don’t usually cover flat nipple surgery if it’s done for cosmetic purposes only. However, if there’s a medical necessity, like recurrent nipple inflammation, then you might be eligible for a rebate.
Take the next step today
With over 20 years of experience as a plastic surgeon, Dr Jeremy Hunt aims to get optimal results using different surgical techniques.
Dr Hunt prides himself on the level of care and attention he offers and that begins from the day of first consultation.
Join the thousands of past patients today by booking a consultation with Dr Hunt at your earliest convenience.
Always Do Your Research
- Browse our FAQs page
Book Your First Consultation
- Your Surgeon Consultation Fee is $400
- You will need a Referral from your GP
- Phone the team or email to Book your consultation
Prepare for your Plastic Surgeon Consultation
- Bring a friend or relative to help discuss the information.
- Take lots of notes and read the documents provided.
- Dress in simple clothes as you may need to undress.
- Bring your GP Referral and your test results.
Considering Inverted Nipple Correction Surgery?
How common are inverted nipples?
Shy Nipples and Flat nipples are fairly common. It is estimated that 2-10% of women have nonprojecting nipples. Experts think that inverted nipples might be even more common than the estimates since many women might not seek medical evaluation.
Should you worry about having flat nipples?
Inverted nipples are usually not very concerning. However, sometimes, nipple retraction can be a sign of breast cancer. If nipple retraction developed after puberty, within a short timeframe (weeks to months), or is associated with nipple discharge, pain, change in breast skin color, or a palpable mass, you should not delay visiting your healthcare provider.
What causes nipple inversion?
Inverted nipples are usually a congenital problem. Women with flat nipples have short milk ducts and hard fibrous tissue on the inside of the nipples, pulling them inward. It’s not exactly known what causes this to happen.
Is an inverted nipple normal?
When it comes to the shape of nipples and breasts, there’s no single normal. Flat nipples are common, and hence can be considered as a normal variant of nipple shape. You don’t have to fix inverted nipples unless they are bothering you.
Can you fix inverted nipples without surgery?
There’s no effective non-surgical way to fix inverted nipples. Nevertheless, a niplette might provide a temporary solution for patients with only mild nipple inversion.
Can you breastfeed with an inverted nipple?
You might be able to breastfeed even if you have flat nipples. You can try to manually bring the nipples out or use a breast pump to make the nipples protrude. However, in more severe nipple inversion, it might not be possible to breastfeed, since your baby would not be able to latch on the breasts with the nipples turned in.
What do flat and inverted nipples look like?
Flat nipples usually do not project outside the areola (the pigmented skin around the nipple). They are contained within the same surface of the surrounding skin. They don’t protrude from the breasts.
Are flat nipples permanent?
Not necessarily. Flat nipples can be temporary. They might go away on their own with time, however, it’s not very likely.
What are Risks and Complications of Inverted Nipple Correction Surgery?
Nipple cosmetic surgery involves very minimal risks. However, on very rare occasions, complications might develop. Some of the rare complications after nipple inversion correction include:
- Inability to breastfeed – depending on the type of flat nipple surgery you get
- Loss or reduction of nipple sensation – temporary or permanent
- Seroma formation – fluid collection in the wound
- Hematoma formation – blood formation in the wound
- Wound infection – redness, pain, and pus, usually treated with antibiotics
- Recurrence of flat nipples – recurrence rate is around 3.9%, that’s 4 in every 100 women
- Wound healing problems – especially in diabetics and smokers
In general, the complications of flat nipples surgery are very rare and manageable in case they occur. It is important to not delay contacting us in case you have concerns about your wound healing.
Further Reading & Medical Sources
- Surgical Correction of Inverted Nipples
- Correction of Inverted Nipple Using Subcutaneous Turn-Over Flaps to Create a Tent Suspension-Like Effect
- Prevalence of inverted and non-protractile nipples in antenatal women who intend to breast-feed – ScienceDirect
- Inversion of the human female nipple, with a simple method of treatment
- The inverted nipple: its grading and surgical correction
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PLASTIC SURGEON SYDNEY
About Dr Jeremy Hunt
Dr Hunt has worked with thousands of patients across his 20-year career. This is reflected in his role as Spokesperson for the ASPS – Australian Society of Plastic Surgery. Dr Hunt is also a Fellow of the Royal Australasian College of Surgeons (FRACS) and Supervisor of Plastic Surgery Training at Sydney Children’s Hospital.
Dr Hunt has a strong interest in helping his patients achieve their desired results by employing the most appropriate practices for each individual patient.