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Breast Augmentation & Breast Implant Information Web - Frequently Asked Questions

About Inverted Nipples As many as 2% of American women have at least one inverted nipple and still the subject of nipple inversion is seldom discussed among friends or in the media. Usually when people discuss breast enhancement, they are talking about enlarging, reducing or lifting their breasts. Clearly nipples are an integral part of the breast, playing a role in appearance, in sexuality, and in motherhood. And for the women who have inverted nipples, inversion may affect their self-esteem and body image. While several different surgical techniques have existed for inverted nipples, now there is a treatment that has been successful with long-term results. Most cases of inverted nipples are congenital — some people are just born that way. However, some nipples become inverted after breastfeeding when scar tissue builds in the milk ducts. Nipples that become inverted after birth are usually caused by one of three things: not enough skin at the base of the nipple, constricted milk ducts, or scarring of the milk ducts due to breastfeeding. Types of Inverted Nipples There are three "grades" of inversion — which basically means three levels of severity. While some nipples may only be inverted some of the time (and "come out" or become everted in response to cold or physical touch), others are more severely inverted and never come out. Some women can breastfeed normally, while others will never be able to breastfeed. Grade 1. Nipples are inverted but can become everted manually (through stimulation) or in response to cold temperature. They can remain everted for some time. Milk ducts are usually not compromised and breast feeding is possible. These are "shy nipples". Grade 2. Nipples are inverted and are more difficult to evert. The eversion almost never lasts — the nipple returns to the inverted state immediately. Breast feeding could be possible, but this is not a sure thing. Grade 3. Nipples are severely inverted and never evert. Milk ducts are often constricted and breast feeding is impossible. Women with Grade 3 inverted nipples may also struggle with infections, rashes, or problems with nipple hygiene. Correction of Inverted Nipples (compliments of Grant Stevens, M.D., Marina del Rey, California) Most people who have inverted nipples are happy to hear about surgical corrections and how simple they can be. Inverted nipple repair is performed on nipples that have been inverted since birth or have become inverted due to breast feeding or other trauma. Recurrence of nipple inversion after surgical repair elsewhere is also a reason that nipple repair may be performed. Dr. Stevens's and Dr. Stoker's unique approach, both in the surgery and the after-care (using the Stevens Stent for traction to ensure the nipple retains eversion), repairs the nipple, retains nipple projection, leaves minimal scarring, and gives a natural appearance. Surgical Correction of Inverted Nipples--Correction for inverted nipples can be done on an out-patient basis. A patient can opt for local anesthesia, intravenous sedation and local anesthesia, or general anesthesia. The surgery consists of a small incision at the base of the nipple while the nipple is in a protected projected state. Then a gentle spreading of the fibers is performed within the nipple (these fibers are what pulls the nipple inward). Special care is taken: the spreading happens parallel to the milk ducts in order to preserve them. Once the fibers are spread and the nipple is free and in an outward, normal position, special sutures (stitches) are placed inside the nipple. If you think of a clock, the sutures go from the 12:00 position to the 6:00 position. Another set of sutures go from the 3:00 position to the 9:00 position. A third suture goes around the base of the nipple. This adds stability and strength to the base of the nipple and helps retain its outward projection. All sutures are dissolving so you won't be required to come into the office to have any stitches removed. The Stevens Stent--Finally a special stent called the Stevens Stent, is placed over the nipple. This stent actually holds your nipple in place and ensures that the nipple heals in an outward position, retaining the integrity gained through the surgery. Not only does it help with the nipples' projection, it also protects the nipple in the healing stages. This stent is left on for one to three days. The sutures dissolve within 10 to 14 days and the initial incision will not be noticeable. To date, none of the nipples corrected have reverted.

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