Most people have naturally protruding nipples. Occasionally however, short milk ducts can develop preventing outward skin bulging in one or both nipples. Abnormality, most commonly becomes notable during puberty. It can be a result of trauma and scarring within the breast ducts, usually as a consequence of problematic breast feeding. If inverted nipples develop in the adulthood, spontaneously and gradually, there might be an underlying breast tissue disease which should be investigated first.

Correction of inverted nipples may be achieved using both, non-surgical and surgical means. I would always encourage patients to explore non-operative options before contemplating surgery despite the latter being predictably more effective.

The most commonly used non-surgical treatment is the nipple suction device; a pump which exerts gentle traction on the nipples and is generally used overnight as you sleep. The gentle traction slowly stretches the milk ducts allowing the nipple to sit in an everted position. It works best for mild problems; less so in patients with severe grades of abnormality. Patience is essential as more stable  improvement is rarely seen in lest then 8-12 weeks.

Most patients, I had an opportunity to treat, would have tried proprietary methods available but found them unsuccessful, after a while. At that point, surgery should be contemplated.

Surgery for inverted nipples is relatively simple and is considered a minor procedure. It is done on a day care basis, usually under local anaesthesia and takes approximately 45-60 min. You will be able to return to normal activities almost immediately.

The incision is made around the nipple so that it is free from the surrounding tissue. The milk ducts which tether the nipple inwards are released and/or divided so that the nipple can come out and its projection improved. Slowly dissolving internal stitches are used at the base of the nipple to hold it in the elevated position whilst it is healing.

Scarring is usually minimal, finely hidden within the lines of nipple/areola complex. Wounds heal within 2 weeks and require minimal dressings and care postoperatively with regular moisturising. Shower/bath is possible after 2-3 days. External scars are hardly of any significance, but internal ones can affect future breast feeding.

The inability to breastfeed after the surgery is the main downside of inverted nipple correction. This is something you’ll need to consider very carefully if you are planning to have a family and would like to breastfeed. Although your nipples may be inverted, it is often still possible to breastfeed. A good guide for this is if the nipple suction device causes eversion and correction of nipples, then the suction of your baby is likely to do so as well.

Overall, inverted nipple correction surgery is very successful in most cases. The pictures in the gallery below illustrate improvement which can be achieved with surgery.