What is an inverted nipple?

            An inverted nipple is a condition in which the nipple does not protrude from the breast projecting outwards but is completely or partially inverted. This is often because the milky pores of the nipple are shorter than normal, which is why the nipple turns inward.

An inverted nipple can occur gradually during childhood or adolescence, when the breast is developing. It can be present in one or both nipples. In some cases, however, the inverted nipple may be acquired and may exist due to a specific inflammation or condition, namely:

  • Pregnancy or breast-feeding
  • Surgery
  • Breast ptosis
  • Mastitis
  • Breast ectasia
  • Tuberculosis
  • Breast cancer


Sudden nipple inversion in a short period of time should be subject to a thorough examination, as it may be a sign of a negative predisposition, such as the appearance of a malignant tumor.

  • The stages of nipple inversion

There are 3 stages of an inverted nipple that are used to determine the severity of the condition and are as follows:

Stage 1: The nipple resembles a typical nipple but has an inward inclination. The milk ducts are not affected, and the woman is able to breastfeed. Usually the nipple can be pulled out if it is pressed with the finger or stimulated naturally by friction or cold.

Stage 2: The nipple is inverted and whenever there is pressure or stimulation, it peaks for a while and returns to the previous state. The milk ducts are also inverted, and the breastfeeding process is difficult, as the newborn baby cannot locate the nipple.

Stage 3: the nipple is permanently inverted, and no attempt is made to stimulate it. The process of breastfeeding cannot be performed. At this stage, the patient must proceed with surgery, because a serious aesthetic and functional problem exists.


  • Who is it for?

The operation is mainly aimed at women who have one or both nipples inverted. However, there is a small percentage of men who undergo this surgery. Applicants must be in excellent general health and must be 18 years of age or older when breast development is complete. Not suitable for candidates who are pregnant, breastfeeding or want to breastfeed in the future. Surgery can make breastfeeding impossible by cutting off the milk ducts.


  • The first visit to the doctor’s office

During the first visit, the Plastic Surgeon is fully informed about the medical history of the person concerned and honestly discusses her motivations and expectations after the surgery. After that, some necessary measurements are made in the area and some photos are taken. Before the definition of the operation and the procedural matters, it is very important to inform the interested party about the results and possible complications.


  • Is nipple insertion surgery painful?

The operation is relatively painless. Mild pain is detected postoperatively, as the nipple is one of the most sensitive parts of the body. However, the degree of discomfort varies from person to person and is treated with appropriate painkillers for immediate relief.


  • What complications may occur?

Restoration of nipple inversion involves some possible complications that may occur after surgery. Some of these are the formation of hematoma or inflammation, hypertrophic scars or the appearance of redness, the concentration of fluid (seroma), the hyposensitivity or hypersensitivity of the nipples, their necrosis as well as their re-reversal. It is worth noting that the patient may lose the ability to breastfeed.


  • What kind of medical tests will be needed before restoring the nipple inversion?

Initially, a preoperative examination is performed, which includes the retrieval of the interested party’s medical history. Those are followed by a series of tests such as general blood tests, a blood coagulation test, a biochemistry test, a cardiogram, and a chest x-ray. In some cases, a mammography or ultrasound may be requested. At the same time, the candidate is advised to stop smoking and anticoagulants.


  • How long does nipple reconstruction surgery last and what kind of anesthesia is required?

The duration of the operation varies from 30 minutes to 1 hour depending on the degree of nipple inversion. In most cases, local anesthesia is used, while general anesthesia is recommended, more rarely, when serious medical reasons are present.


  • During the operation



There are two ways to repair an inverted nipple related to whether the milk ducts are cross-sectional or not. The Plastic Surgeon first makes an incision at the base of the nipple to free access to the milk ducts that pull the nipple. At that point the surgical method that has been chosen based on the degree of nipple inversion and the personal thoughts of the candidate will be followed.


  • Mild nipple inversion: The short milky pores stretch and push the nipple outward. If the milk ducts do not intersect, there is a good chance that the patient will be able to breastfeed. However, there is a risk of re-inversion of the nipple.
  • Intense nipple inversion: The short milky pores are cut or separated to stop the nipple from being pulled inward. If the milk ducts are cut, the patient’s involvement in the breastfeeding process is affected and she may not be able to breastfeed. However, the chances of the nipple being re-reversed are reduced.

After that, the skin is sutured, and the nipple is repositioned.


  • After the operation

The patient, if she has not undergone general anesthesia before, can leave the clinic as soon as she fully regains consciousness. A protective patch will already have been applied to the wider area of ​​the nipple to prevent any abrasion or injury. Postoperatively, edemas, ecchymoses and redness will appear in the affected area, which with the help of analgesics will subside after 1-2 days.


  • In how many days can one return to their daily activities?

After the operation, the recovery will occur quickly, within 3 days. Thus, the patient does not need to withdraw from her daily activities and can continue her work after those days have passed. Strenuous activities are to be avoided for about 2-3 weeks.


  • Results

The improvement of the nipple is felt immediately. The results are finalized within 3-4 weeks and can last for many years. The nipple no longer looks deformed, it reflects a more natural shape with its aesthetic restoration and the patient’s appearance is improved by giving her confidence and enhanced self-esteem.

Get proper and responsible information from the Plastic Surgeon Akis G. Karamatsoukis.

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