Breast surgery – for aesthetic breasts
Inverted Nipples
Inverted nipples are usually a developmental disorder, resulting in the absence of a normal prominent nipple. They can be present bilaterally or on one side only and can be complicated by repetitive inflammations. Inverted nipples are below the skin level and sometimes do not come out even with mechanical or temperature stimulation. Inverted nipples are due to short, underdeveloped milk ducts surrounded by tight fibrous strands. If normal prominent nipples have been present for years and if the nipple has retracted secondarily, any underlying malignant or inflammatory breast disease which can cause this retraction must be ruled out both clinically and by mammogram and / or ultrasound.
Conservative measures to keep the nipple outside by a suction device (“nipplette”) or a nipple piercing are usually unsuccessful in the long run. The operative correction of inverted nipples however is very successful and usually not painful.
I perform the procedure under local anesthesia as described by Olivari. The ducts are released through a small incision between nipple and areola and the nipple is pulled outwards. A special subcutaneous suture prevents retraction. This immediately results in a natural and attractive aspect of the affected breast. Tight bras should be avoided for 3 weeks. If a nipple piercing is planned additionally, it can be applied 3 months after the operation.
Complications are very rare and include temporary or permanent changes in sensation of the nipple.
Wound healing disturbances are rare if you refrain from smoking for 3 weeks. As breast feeding was usually impossible with the inverted nipple anyway, the persistent inability after the operation is usually not regarded as a problem. Recurrent inversions are rare with this technique.