Inverted nipples are nipples that go inward or lie flat against the areola. The areola is the circular area of pigmented skin surrounding the nipple. Also known as retracted nipples, these nipples can be present since birth or developed later in life. Both males and females can have them, although it is more common in females. It is roughly estimated that 10-20% of women naturally have inverted nipples. Nipple inversion almost always has absolutely no impact on a person’s health, sensitivity, or ability to breastfeed; therefore it is usually not a cause for concern. There is no medical need to change it. It can often be temporarily corrected through manual stimulation. Permanently inverted nipples can be corrected through surgery, and many people choose to do so for aesthetic reasons.
Inverted nipples are more common than you may think. Did you know that inverted nipples, are included among common nipple types? In rare cases, nipples may change due to underlying conditions, so visiting an experienced nipple revision surgeon is an excellent way to have your questions answered and learn about options.
Our surgeons are Royal College certified plastic surgeons with more than a decade of experience helping people restore body confidence.
Nipples can be inverted in both men and women, and you may have only one side showing a flat or tucked-in nipple. The condition is also referred to as retracted nipples. While congenitally inverted nipples (which have always appeared the same) are not usually associated with medical problems, developing inverted nipples later in life may be concerning.
Our surgeons will ask you questions about your health, family health history, and other potential symptoms. They will examine you and let you know if you should pursue any additional assessment.
Inverted nipples are just that—inverted. They’re nipples that go inward or lie flat against the areola. There are three grades by which nipple inversion is classified. These grades describe how serious the condition is based on the degree of inversion and the likely effect of inversion on breastfeeding.
Grade 1: The nipple inversion can be reversed by simply placing your thumb and index finger on the areola and gently pushing or squeezing it out. The nipple usually stays out for some period of time. You can still breastfeed. Breastfeeding and stimulation can also help draw the nipple out, along with a decrease in temperature.
Grade 2: Although the nipple can be pulled outward manually via the method described in Grade 1, when released it will likely revert back almost immediately. It may also be harder to pull out manually than Grade 1 inversion. You may have some difficulty breastfeeding.
Grade 3: It is impossible to pull the nipple out manually and you cannot breastfeed.
Congenitally inverted nipples relate to adhesions under the nipples binding them tightly to underlying tissue. It is estimated that 10 to 20 percent of women naturally have this nipple type. Direct stimulation or cold temperatures may change their shape and cause them to protrude temporarily. The condition does not necessarily prevent breastfeeding, and there is no medical need to change them, but many people wish to correct inverted nipples for aesthetic reasons. There are numerous reasons why someone may have nipple inversion. Common causes include:
It is important to have nipple inversion assessed by an experienced surgeon because in some rare cases, inverted nipples are caused by underlying conditions. Visiting one of our board-certified surgeons is an excellent way to have your questions answered and learn about options.
At TMSC, we understand that making changes to your body requires careful thought and planning. Our surgeons take the time to answer all of your questions or concerns about pre-planning, the procedure itself, as well as the recovery period. We ensure that every patient has ample time to discuss their unique situation, goals, concerns, and special considerations.
In most cases, nipple eversion is a very straightforward procedure known as the release and secure technique, a same-day procedure performed while the patient is awake with local anesthesia. During this simple surgery, your surgeon will make a small incision along the base of the nipple. This frees the milk ducts from the tissue that surrounds them. As a result, they don’t continue to pull your nipple inwards. The new protruding shape of the nipple is positioned optimally before being secured via sutures. The nipple then heals.
Post-surgery, nipple sensation may increase or decrease. Furthermore, patients will likely lose the ability to breastfeed through the respective breast. However, any scars or marks left by the incision(s) are as discreet as possible. We always take special care to minimize scarring during every surgery. During post-operative visits, your surgeon will guide you through healing well. Once healing is complete, any signs of surgery will be virtually invisible to others.
There are different areola sizes. Usually, plastic surgeons set the areola size to around 38-48mm. Our surgeons are board-certified plastic surgeons and have more than 15,000 combined surgeries under their belt. They take into account the patient’s preference as well as aesthetics before making this decision.
As discussed, the usual areola diameter that most surgeons suggest is between 38mm-48mm. This size usually matches the overall breast mound. But if our surgeon finds out that the area is already smaller than 48mm, they save the entire areola area. If the areola is larger than the preferred size, he generally trims away the excess area. But they always take aesthetics and patients’ preferences into account.
During breast surgery, the size and shape of the nipple usually stay the same. But that is not always the case. Depending on what you want and what is aesthetically pleasing, our surgeon might suggest a change.
Our surgeon starts by drawing a circle around the areola with the nipple as the center. Once that is done, they make an incision on this circular line. Our surgeon then removes all the areola tissues outside the line to place the new areola there.
Thanks to technology, there are various techniques that our surgeon uses for nipple revision surgery. The technique that they choose usually depends on the length and the diameters of the nipples. Our surgeon usually removes a portion of the nipple skin while ensuring that the milk ducts and nerves are intact.
Widening the scar is a possibility with any surgery, and the same is true for nipple revision. Usually, our surgeon performs the surgery so that the periareolar scars blend in with the natural contrast of the breast and areola colours. A revision can be performed if there is a widening or stretching of the scar. Our surgeon will discuss all of this with you during the initial consultation. If necessary, they will call you for follow-up visits to minutely examine the scars and suggest what to do about them. If they find it necessary, they could even place a permanent “purse-string” stitch around the areola, which keeps the breast skin from around the areola from stretching. But this is rarely needed.
Yes, our surgeon ensures that they are available for the patient in every consultation and follow-up visit. They also consider the patient’s preferences and aesthetics when deciding the size and placement of the nipple or the areola.
Multiple factors might affect the widening of the nipple/areola complex. It could be due to genetics, the weight of the breast, elasticity of the skin, age, and more.
Generally, our surgeon places the nipple/areola complex in a forward-facing position. But they makes sure that it is also centered on the breast mound and conforms to the breast shape.
Different people react to the surgery in different ways. Mostly, the colour of the nipple/areola complex remains the same, but in some cases, lightening or darkening of the pigments has been observed.
Most women are completely numb right after the surgery. Some are partially numb. But in most cases, the sensations come back after a little while. Our surgeon will thoroughly examine you after the surgery and recommend what’s best. If you don’t have any sensation after the surgery, you can discuss it with the surgeon during the follow-ups. Unlike most plastic surgeons who are only present for the surgery, and all the consultations and follow-ups are performed by our surgeon; and they are always present for every one of your appointments.
Nipple hypersensitivity is not as common as numbness. But it does sometimes happen. Usually, it is resolved over time. If you are feeling it, make sure that you keep your nipples/areolas moisturized and protected. Our surgeon will take you through the entire process during your follow-up visits. He will also give you advice on how to desensitize the area.
Our surgeons have helped over 15,000 patients thus far. Today, he completes roughly 600 breast surgery cases per year. By his admission, Dr. Tutino is “in the prime of his career.” They not only perform the most leading-edge plastic surgery techniques, but also teach other surgeons as well.
Our board-certified plastic surgeon will meet with you to listen to your concerns, examine you, and recommend a plan to help you reach your body goals.