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Inverted Nipples LAWritten by Dr. Babak Dadvand
An inverted nipple is a nipple that does not protrude. It can occur in one or both breasts and can affect men and women. Many women may be affected by at least one inverted nipple. Having an inverted nipple in LA can have a psychological impact, causing the person to be self-conscious. It can also cause functional problems such as the increased risk of infection and difficulty breastfeeding. Some people are born with inverted nipples. Others may develop inverted nipples after breastfeeding, breast surgery, or trauma. In these cases the underlying cause of the inversion is scarring of the lactiferous ducts, causing shortening and pulling in of the nipple. Men who have undergone gynecomastia surgery may develop inverted nipples afterward because of decreased support to the nipple, scarring of the tissues below the nipple, or both.
Inverted nipples are classified into three grades.
Grade 1: The nipple is inverted but easily protrudes with stimulation and remains out. This is sometimes referred to as a “shy nipple.” There is minimal fibrosis of the tissues underneath the nipple. Grade 1 inverted nipples are typically not associated with functional problems.
Grade 2: The nipple is inverted but can be pulled out, but not as easily as in Grade 1. Also, once released, the nipple goes back to its inverted position. There is moderate fibrosis, or scarring, of the tissues underneath the nipple. Grade 2 inversion may be associated with functional problems such as difficulty breastfeeding.
Grade 3: The nipple is inverted and cannot be pulled out. The amount of fibrosis is severe and the ducts are extremely shortened. Grade 3 inversion is associated with functional problems such as difficulty breastfeeding.
The treatment of inverted nipples is straightforward and depends on the Grade of nipple inversion. The procedure is done under local anesthesia. For Grade 1 nipple inversion, after the local anesthetic is injected, a small incision (2-3mm) is made at the 6 o’clock position of the nipple and a suture is placed in a purse-string fashion around the entire base of the nipple. The suture is then gently tightened. This acts as a support for the nipple to stand on. For Grade 2 and 3 inverted nipples, after making the incision, the scarred tissue is carefully released and a similar purse string suture is then placed. There is no guarantee that the patient will be able to breastfeed after having inverted nipple procedure and this must be discussed before the procedure is undertaken. Other risks include re-inversion, nipple asymmetry, and sensation changes as well as possible disruption of blood supply to the nipple.
Nipple inversion surgery can be done under local anesthesia with minimal downtime and minimal pain. The results can lead to an increase in self-confidence. Most patients return to work in 3-7 days. Exercise and strenuous activity is limited for 2 weeks.
Schedule a consultation with our Los Angeles breast surgeon Dr. Babak Dadvand to learn more.