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Inverted Nipple Correction

For many women, having inverted nipples can be distressing. Lying flat against the breast or actually pulling in from the breast surface, they can be a source of self-consciousness and breastfeeding problems.

Inversion of the nipple is caused by a short milk duct system running from the chest wall to the nipple. Women with inverted nipples basically have a choice of two types of procedures.

Regardless of procedure chosen, inverted nipple repair can restore the nipple to a beautiful and natural, projecting appearance.

If you're considering inverted nipple repair, the following information will provide you with a good introduction to the procedure involved. For more detailed information about how this procedure may help you, we recommend that you schedule a consultation with Dr. Kremer / Dr. Zettl.

What are the most common benefits of this surgery?

Surgical procedures to correct the inverted nipple can be divided into two types: those that leave the milk ducts intact and those that do not. In either case, the objective is to reshape the nipple and areola so that the nipple projects out from the breast, enhancing the appearance of the breast while preserving sensitivity of the nipple. The technique that leaves the milk ducts intact can also help preserve a woman’s ability to breastfeed.

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What will happen at the initial consultation?

During the initial consultation, you and Dr. Kremer / Dr. Zettl will discuss the changes that you hope to see in the appearance of your breasts. Dr. Kremer / Dr. Zettl will begin with a breast related medical history and will then examine your breasts.

He will explain the different options available to you, the procedure itself, and its risks and limitations as well as the kind of anesthesia required.

Take this opportunity to ask all the questions you have about the surgery. Learning everything you can about your options, risks and benefits is the key to making an informed decision.

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How is inverted nipple correction surgery performed?

Techniques used today fall into two categories: those that preserve the milk ducts and those that do not.

Inverted nipple repair with partial preservation of milk ducts: Dr. Kremer / Dr. Zettl will administer a local anesthetic as well as a sedative to help you relax. An incision will be made just around the base of the nipple on the areola.

The nipple and areola tissue is lifted from (but still connected to) the breast and stitched into a new, projecting shape utilizing a “purse-string” style of suturing (stitches). Because of the circular shape of the scar around the nipple, scar contracture will actually increase rather than decrease nipple projection. Medicated gauze is then applied to the site.

Inverted nipple repair with detached milk ducts: This procedure is much more common and may be necessary in more difficult cases. An incision is made at the nipple base, and the shortened milk ducts are detached, allowing a natural-looking projection of the nipple. The incision is sutured closed, and medicated gauze is applied to the site.

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How long does the surgery take?

Inverted nipple repair takes one to two hours, depending on the technique used and the anatomy of the patient.

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Will I have to stay in the hospital?

Probably not. Most inverted nipple corrections are performed as outpatient procedures. Most patients are able to return home within a few hours of the surgery.

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How much pain is there?

Your nipples will be sore after the procedure, but this soreness will probably subside within a few days. Most patients report that this discomfort is easily controlled by medication.

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What can I expect after surgery?

Your nipples will be covered with medicated gauze. Under the gauze will be tiny, stitched incisions. You may feel a little groggy, which is a side effect of surgery and your body’s efforts to heal. Because of the localized nature of the procedure, this grogginess should subside in a day or so. Most likely, you will be allowed to leave the office or day surgery unit within a few hours after the surgery, but you should have someone else drive you home. You will probably be allowed to shower the next day.

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What is the recovery period like?

Most often, swelling is mild to moderate, peaks two or three days after the procedure, and then disappears rapidly over the following three weeks. Most patients report little or no bruising. Sutures (stitches) will dissolve by themselves. You will probably be able to return to work within the 24 – 48 hours, unless your work involves strenuous activity.

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What is the long-term outcome like for most people?

Both techniques: The new nipple projection is permanent. Sensation is almost always unchanged. Because the incisions are at the nipple only, scarring is scarcely visible.

Parachute-flap technique (preserving ducts): Because some of the milk duct system is still attached to the nipple, breastfeeding is likely but cannot be guaranteed.

Detached duct technique: You will not be able to breast feed.

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Ideal Candidate:

In general, the best candidates for inverted nipple correction are:

18 years of age or older
Not currently pregnant or nursing
In good physical health
Psychologically stable
Realistic in their expectations
Having this surgery for the first time

The above is only a partial list of the criteria that Dr. Kremer / Dr. Zettl will consider in determining whether or not this procedure is appropriate for you.

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Other important information

Women who want to correct inverted nipples in order to breastfeed more easily should know that they have other options in addition to plastic surgery. First of all, contrary to popular belief, breastfeeding does not involve the nipple so much as the breast itself, and a hungry infant can achieve quite a vacuum, pulling a moderately recessed nipple out into his/her mouth. Many women interested in breastfeeding are concerned that their nipples are inverted, whereas in reality their nipples will serve quite adequately - when the time comes - without medical assistance. The true inverted nipple is reportedly rare. It is characterized by a tendency to retract when the area around the nipple is squeezed. A flat or even slightly recessed nipple will not necessarily prevent successful breastfeeding.

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Risks and Limitations

All operations carry some risk and the possibility of complications can include (but are not limited to) infection, excessive bleeding, and adverse reactions to anesthesia. The ability to breastfeed cannot be guaranteed after any surgery to correct inverted nipples.

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Be sure to

Tell Dr. Kremer / Dr. Zettl about any allergies you have (to foods, drugs, environmental elements)
Tell Dr. Kremer / Dr. Zettl if you have a history of bad scarring, such as keloids.
Tell Dr. Kremer / Dr. Zettl about all medications, herbal supplements or natural supplements you are taking (both prescription and non-prescription)
Carefully follow any instructions Dr. Kremer / Dr. Zettl gives you regarding eating and drinking and smoking.
Avoid aspirin and aspirin-containing medicines for two weeks prior to surgery.
Arrange for someone to drive you home after surgery or after discharge from the day surgery center or the hospital.
Please inform Dr. Kremer / Dr. Zettl immediately in case you should experience fever or symptoms of an infection after surgery.
Try to schedule surgery at a time other than your menstrual period.

The information on this web site is only intended as an introduction to this procedure and should not be used to determine whether you will have the procedure performed nor as a guarantee of the result.

The best method of determining your personal options is to schedule a personal consultation with Dr. Kremer / Dr. Zettl. He will be able to answer specific questions related to your situation.

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