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Correction of Inverted Nipples

Article Contributed by Dr. Tom Pousti, San Diego, CA

Many men and women have inverted nipples (either one or both) but don’t feel comfortable discussing it with their doctors. Inverted nipple repair is rarely thought of when patients consider breast enhancement. The procedures that are normally thought of are breast enlargements, breast lifting or breast reductions. For some patients, they not only want the breast size taken care of, but also have concerns regarding their nipple and/or areola-- the nipple is the projected part and the areola is the dark pigmented skin that surrounds the nipple. Patients are happy to hear it’s a simple procedure to enhance the nipple/areola. Whether the nipple is inverted, too big or protruding too far, Dr. Pousti can assist you with correction.

The nipple is an important part of a woman’s appearance and sexuality. Inverted nipples affect the body image of both men and women. Inverted nipples are congenital most of the time – sometimes the nipples become inverted after childbirth and/or breast feeding.

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

Patient’s are happy to hear that inverted nipple procedures are minimally invasive and can be performed in conjunction with other procedures such as breast augmentation, breast lifting or breast reduction surgery (for both men and women). This procedure is performed in our outpatient surgery center under either local or general anesthesia.
Surgical Correction of Inverted Nipples

The surgery consists of a small incision at the base of the nipple. Milk ducts are identified and divided – this allows the nipple to remain spontaneously everted. A suture is used to support the eversion and closure of the suture line is accomplished. Usually, only dissolving sutures are necessary.

Article Contributed by Dr. Tom Pousti, San Diego, CA

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