Nipple

Inverted nipple repair

BEFORE & AFTER PHOTOS

*DISCLAIMER: This site contains graphic & surgical images that may be disturbing to some viewers.

This site is intended for individuals over the age of 18.

**Please note that none of the images posted throughout this site have been enhanced or photoshopped.

BREAST NIPPLE INVERSION

What is an Inverted Nipple?

A typical female nipple will project from the surrounding areola and breast to form the apex of the breast. The amount of nipple projection varies greatly. This projection is exaggerated when a person is cold or excited. This is because the muscle within the areola and nipple contracts when stimulated, to increase the nipple projection and reduce the size of the areola. The nerve that carries sensation to the nipple is also responsible for stimulating this muscle to contract. If this nerve is damaged, the sensation to the nipple is lost, in addition to the nipple’s ability to project with stimulation.


What happens with an inverted nipple?

  • There are about 20 ducts (lactiferous ducts) that drain the breast lobules which produce the breast milk. This breast milk drains from the breast lobules through the lactiferous ducts to the nipple during breast feeding. This allows the infant to successfully breast feed.

  • If the ducts do not develop properly, there is no connection between the breast lobules and the nipple, so the breast milk cannot be delivered to the infant.

  • If the nipple is severely inverted then the lactiferous ducts have not developed properly and are severely tethered. There is no connection between the breast lobules and the nipple. Even with manual manipulation, the nipple will not evert. In this circumstance, successful breast feeding is unlikely.

  • There may be varying degrees of this tethering effect from underdeveloped lactiferous ducts. Patients with a lesser degree of nipple inversion and tethering may still be able to breast feed.

  • In some instances, the loss of breast volume from weight loss or loss of breast volume after pregnancy and breast feeding may lead to nipple inversion. This is caused by the loss of the underlying breast tissue to support the nipple. It then collapses.

  • There are certain types of breast cancer that present with nipple inversion and a bloody nipple discharge. A sudden change in the nipple should be assessed by your physician and appropriately investigated and the patient referred to a breast cancer surgeon.


Can an inverted nipple be corrected?

The correction is surgical and will eliminate any future possibility of breast feeding.

If the patient has a mild to moderate nipple inversion and wants to breast feed, the correction should be delayed until after she has completed her family and has had a trial of breast feeding. With mild to moderate nipple inversion, there may still be the opportunity to successfully breast feed.


OPERATION:

  • This procedure is done under local anaesthesia (freezing)

  • There are numerous techniques described to correct the inverted nipple:

    • There is an incision made around the nipple and areola area.

    • The tethered lactiferous ducts are divided and released (that is why breast feed after the surgery is not possible) which allows the nipple to project.

    • Local breast tissue is then used to support the newly projected nipple.

    • The incision is closed with dissolving sutures.

  • Healing takes 7-10 days

  • If the loss of nipple projection is caused by loss of breast volume, and the patient wants to increase the breast size, then a breast augmentation procedure may restore the nipple projection by increasing the underlying support of the breast tissue and nipple.

    *Please See FAQ Breast Augmentation


RISKS:

With any surgery there are surgical and anesthetic risks.

Aside from the rare risks of an anesthetic event, some of the general and specific surgical risks for this procedure would include:

  • Scarring 

  • Nipple tissue loss

  • Infection

  • Sensation change to the nipple

  • Discomfort

  • Asymmetry

  • Bleeding (hematoma)

    • if you take blood thinning medication, this must be stopped at least one week prior to surgery and one week after surgery

*This list is not complete.

During the consultation with the patient, Dr. Giuffre will outline and explain each of the risks in detail.


THE FOLLOWUP:

How often do I need to come back for a checkup after the surgery? 

Postoperative visits include:

  • a 1 week post op visit

  • a 6 week visit in the office to review the preoperative photograph and the surgical result.

The patient is allowed to shower the following day. Aggressive sports activity should be avoided for 2 weeks.

 If there are any patient concerns, Dr. Giuffre provides his home phone number for patient's direct access.

After the 6 week visit, if there are any future requests for an appointment, they are made directly with Dr. Giuffre’s office and an expedited visit is arranged.


FINANCING:

Will AHS (Alberta Health Services) cover Nipple Inversion surgery?

Nipple inversion correction breast surgery is not covered by Alberta Health Services.


Can I finance the costs of the surgery? How do I do this?

Dr. Giuffre does not provide in house financing for cosmetic procedures. 

There are a number of companies across Canada that will finance cosmetic surgery, similar to car financing or mortgages.

Please refer to the links provided on the Home Page for this information. Dr. Giuffre has no financial or business relationship or affiliation with any of these companies.