Most conversations about breast surgery revolve around the size and shape of the breast. However, three to ten percent of people have a condition known as inverted nipples; when the nipple lies below the surface of the skin and doesn't protrude from the areola.

Consequences Of Nipple Inversion

Inverted nipples can be uncomfortable and embarrassing to the women who have them. Many women might not even consider this to be a fixable issue; however, there are many treatment options available.

Inverted nipples can cause irritation, inflammation and complications in breast feeding. They may also cause emotional distress due to their unusual appearance. For these reasons, many women chose to have surgery to correct the issue.

Grades Of Nipple Inversion

The article “A New Surgical Procedure for the Very Severe Inverted Nipple” by Sanghoon Han and Yoon Gi Hong divided inverted nipples into three grades based on the severity of the condition. As the grade increases so does the complexity of the surgery involved.

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  •  Grade 1: You can manually squeeze or roll the areola to cause the nipple to protrude. The nipple remains protruding for a long while. The nipple may also protrude in reaction to stimuli such as ice or a breastpump. Fibrosis, a frequent cause of inverted nipples, at this grade is minimal.
  • Grade 2: It is possible to cause the nipple to protrude manually, but the nipple recedes again shortly. Here there are moderate amounts of fibrosis.
  •  Grade 3: The nipple cannot be forced to protrude without surgery and fibrosis is pervasive.

There are many different surgery options available for each grade. You should talk with your doctor about each of them and decide which one is right for you.

What to Expect from Surgery

There are at least twenty different types of procedures, from non-invasive to surgical, to correct inverted nipples. Some common procedures:

  • “Purse-string” sutures, which hold the nipple above the areola
  •  A small incision that will allow the doctor to sever the fibrosis that prevents the nipple from protruding
  •  Inserting a prosthetic nipple under the skin

Which one you undergo depends upon the cause and severity of the nipple inversion, as well as the doctor’s preference.

Typically though, most plastic surgeons report that nipple inversion surgery is an outpatient procedure that lasts less than an hour. The recovery time is between two to seven days, and the associated pain and discomfort is minimal.

Operations and procedures on grades I and II inverted nipples usually preserve the ability to breastfeed. If you have grade III inverted nipples caused by heavy fibrosis, the risk of cutting the lactiferous ducts increases and you may lose the ability to breastfeed from the affected nipple.

Qualified Candidates And Possible Side Effects

Some doctors suggest you should not get this surgery if you are pregnant or breastfeeding, under 18 years old or incapable of understanding the pros and cons of the procedure.

Although the operation is generally considered safe and has a high success rate, possible side effects to the surgery can include: re-inversion of the nipple, soreness, numbness/lack of sensation and an inability to breastfeed.

Nipple inversion can be present from birth or appear during breast feeding, due to the changing size and shape of the breast. It can also be a side effect of more serious issues, such as breast cancer or other disorders and diseases. If your nipples invert you should see your doctor to determine the cause.