Correcting Inverted Nipples

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Inverted nipples is a condition that affects three out of every 100 women. Plastic
surgeon DR GRANT STEVENS explained to Sally Waddington how this can be corrected.

According to plastic surgeon Grant Stevens
M.D., there are two types of inverted nipples: densely inverted and shy. “Shy nipples can
be drawn out with physical stimulation – either sexually or for breast-feeding,” said Stevens. “If they
never come out even when aroused or in very cold
water, then I call them densely inverted.” Shy nipples
may only cause cosmetic and psychological
problems whereas densely inverted nipples also
have functional repercussions, such as the inability
to breastfeed or infection or irritation of the nipple
when natural secretions become trapped.

“Up to as many as half the patients we see have
some kind of functional complaint,” told Dr. Stevens.
While a procedure to correct inverted nipples can
have a great impact on the patient’s psyche and
correct irritation problems, the ability to breast-feed is
not guaranteed. Dr. Stevens warned: “Do not expect
this operation to allow you to breast-feed. That’s a
bonus, but it may not happen.”

Before the procedure begins, Dr Stevens numbs
the nipple and areola with an ice cube or pack, before
administering a local anesthetic using a tiny needle,
the size of a hair. This means the patient experiences
little or no pain, despite the sensitivity of the area.

The surgery itself can be broken into three stages.
During the first stage, an incision measuring 1/4 inch
(3-4 millimeters) is made in the lower portion of the
nipple. He then releases the ducts that are pulling
the nipple down. The nipple is drawn out with much
care. “The idea is to place as little trauma on the
duct or nipple as possible, because you want to
preserve the ability to breast-feed,” said Dr. Stevens.

The surgeon then makes a series of sutures
around the nipple. If the nipple is imagined like a
clock, the sutures run from 12 to 6 o’clock, then
again from 3 to 9 o’clock. By bunching up the tissue
around the nipple, these sutures create a new
pedestal for the nipple to rest on. A dissolving
“purse-string” suture is made around the base of the
nipple, weaving in and out of the skin, which
tightens the base of the nipple.

Finally, Dr Stevens places a small plastic “stent” –
like a tiny medicine cup – over the newly extracted
nipple. As well as holding it in the upright position, this
stent protects the nipple from irritation – patients can
wear a bra and clothing without damaging the tender
area. The stent stays on for four to six days after the
operation. The patient then returns for a follow-up visit
to remove the stent and the process is complete.

Post-operatively, there is little care needed. While the
stent is on, patients cannot get the area wet and sexual
contact is discouraged for the first week after surgery.
Occasionally the patient may need an ointment to aid
the healing, although this is rare. The wound heals very
quickly – to the point where the scar is usually invisible
by the time the patient returns to have the stent
removed. Possible complications include the retraction
of the nipple, or a local infection. However, after
performing over 50 of these operations, Dr Stevens has
never had a case of either of these complications.

The correction of an inverted nipple is a procedure
that can greatly assist both the self-esteem of the
sufferer and the function of the breast.