Inverted nipple and treatment

What is an inverted nipple?

An inverted or inverted nipple is the nipple bouncing backward, where it is not protruding as usual. It is worth noting the need to distinguish between an actual inverted nipple according to reasons that we will refer to later & the shy nipple that tends to rebound inward, but it can emerge naturally when exposed to cold or some massage and massage on it. It is noted that most cases of inverted nipples do not have any negative health effects on the mother, as their negative impact is limited to the issue of breastfeeding only. But at the same time, it is worth noting that an inverted nipple may be an important indicator that calls for a visit to the doctor, in order to exclude the possibility of breast cancer, inflammation of the breast tissue or obstruction of the milk ducts … etc.

What are the degrees of an inverted nipple?

The first degree: It is the inverted nipples that protrude by simply pressing the surrounding dark area, and even remain prominent for a period of time. An inverted nipple of first degree does not interfere with breastfeeding at all.
The second degree: the inverted nipples that arise with difficulty upon pressure on the surrounding dark area, and will regress once the effect of the pressure subsides. Most cases of second-degree inverted nipples interfere with breastfeeding.
The third degree: the inverted nipples that do not respond at all to the effect of pressure on the surrounding dark area, and are usually accompanied by the presence of fibrosis or shrinkage of the milk ducts. All cases of inverted nipple of the third degree conflict with breastfeeding, where breastfeeding is impossible.

Inverted nipple stairs

What are the causes of inverted nipple?
Most cases of inverted nipple are a congenital defect from birth, but it does not appear until adulthood and breast development is complete.
Some medical studies indicate that too much breastfeeding may be a cause of inverted nipples.
Sometimes obesity may affect the shape and consistency of the breast, as obesity causes the breast to sag, which in turn causes the nipple to turn inward. Also, breast sagging even without obesity (especially with age) may also lead to an inverted nipple.
Doctors stress that an inverted nipple may be one of the primary indicators of breast cancer, especially if it is associated with other symptoms such as itching or secretions from the breast.
In the event that surgery is performed on the nipple or in the surrounding dark area (as in cases of breast augmentation or breast reduction), the surgical scars that form may cause the nipple to retract inward, and the inverted nipple to develop.
How can an inverted nipple be treated?
Cases of the first degree and some cases of the second degree of inverted nipple are treated through simple traditional methods such as the Hoffman method, which includes placing the thumbs around the nipple, then pressing and moving circularly around the nipple repeatedly, and it is noted that the effect of the Hoffman method is temporary, so it is recommended that the application be This method is combined with the use of nipple suction devices that enhance the erection of the nipples or a breast pump. In the event that the above fails to achieve the desired effect (some cases of second degree & all cases of third degree of inverted nipple), then the corrective surgical option is the most appropriate.

Treating an inverted nipple surgically
Usually, the parts that pull the nipple inward are released during surgery. This operation must be done using microsurgical technique and special magnifying glasses to avoid damaging the milk ducts. After that, the support tissue can be transferred from the surrounding tissues to the base of the nipple so that the tip does not come back in. This can be done using various sewing techniques.

In another important case, the importance of surgery is to obtain a normal image and maintain the natural feeling of the nipple. Care is taken to protect the nerve structures that provide sensation to the nipple during the procedure.

Treating nipple enlargement surgically:
Nipple enlargement may occur more than usual during adolescence or it may occur after birth. In general, this aesthetic difference is required to be corrected by breast reduction surgery.

This enlarged nipple size can also be seen in women who are not large breasts and can be corrected with a very simple operation. In such cases, the problem can often be corrected with a small intervention performed under local anesthesia. If this type of surgery is performed using magnifying glasses and microsurgical techniques, successful results are obtained. After the operation, you can get the shrinking nipple, the natural feeling and the delivery of milk to your baby with ease.

The brown area (areola) around the nipple can be very large. This area can be narrowed and reduced to aesthetically acceptable dimensions.

Surgically reconstructing the nipple:
Nipple repair or reconstruction is the reconstruction of the brown region around the nipple and areola around the nipple in the event of congenital absence or subsequent nipple defect. Partial or complete loss of the nipple may occur due to causes such as breast cancer, infection, burns, and trauma. There are different ways to restore the brown area called the areola, the nipple, and the surrounding area. These methods can be divided into two methods, which are performed by taking tissue from the body or providing it externally. Skin patches taken from other parts of the body can be used and shared on two breasts if there is a hard nipple, and tissue transfer techniques that cannot be from the dark skin around the hard nipple can be used.

The nipple is usually repaired 6 to 12 months after breast cancer after breast repair. It can be planned as the only symmetrical surgery with the contralateral breast or it can be performed with other breast surgeries.

The absence, deformation, or inconsistency of the nipple with the breast may cause discomfort in women and thus require aesthetic surgery. It is one of the sensitive operations required.

There are several specific methods of nipple reconstruction. But one of the most reliable methods is the local flap method. It is created under local anesthesia using tissues in the specific area of the breast. Nipple reconstruction is done using a technique called “Ying yang nipple reconstruction technique”, which was developed by our medical team in this field and scientifically brought into the plastic surgery literature.