As many as 2% of women and men have at least one inverted nipple. Varying degrees of nipple inversion exist from “shy” to severely retracted. In most cases inverted nipples are congenital; some people are just born that way. However, sometimes nipples can become inverted after breastfeeding when scar tissue builds around the milk ducts from infection in the ducts or as a rare complication after breast surgery. Nipple inversion after birth is usually caused by one of three things:

• not enough skin at the base of the nipple
• constricted milk ducts
• scarring of the milk ducts due to breastfeeding

Varying degrees of nipple inversion exist: Grade 1 - Nipples are inverted but can become everted manually through stimulation or in response to cold. Grade 1 nipples 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 is often extremely difficult. Grade 3. Nipples are severely inverted and never evert. In these cases, the actual nipple may be smaller in size or may not be fully developed. 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. The objective of inverted nipple correction is to evert the nipple, so that it projects out from the surrounding areola, enhancing the appearance of the breast while preserving sensitivity of the nipple. The technique that leaves the milk ducts intact can also help preserve a woman's ability to breastfeed. Dr. Reid or Dr. Gordon will do a thorough examination to determine which procedure is right for you. The most common procedure is described below: Inverted Nipple Correction: The procedure is performed in our office under local anesthesia and takes less than 1 hour. The surgery consists of a small incision at the base of the nipple while the nipple is in a protected projected state. A gentle release of the fibers that pull the nipple inward is performed, making every attempt to preserve the milk ducts. Once the nipple is freed and in an outward, normal position, special sutures are used to hold the nipple at its new projection until it heals. 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. The sutures dissolve within 10 to 14 days and the initial incision will not be noticeable. Recovery is rapid and return to work is often within one day following surgery. When correction of nipple inversion surgery is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Correction of nipple inversion may be performed as an isolated procedure or in combination with other breast surgeries.