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What are inverted nipples?

An inverted nipple is a nipple that is turned inwards into the breast rather than pointing outwards. Inverted nipples are mostly congenital and are not uncommon, affecting up to 20% of men and women. It may affect one or both sides.

Tagged: Body & Breast

Author: Mr. Bryan Mayou, MB ChB FRCS

Date: 11th December 2020

What are inverted nipples?

An inverted nipple is a nipple that is turned inwards into the breast rather than pointing outwards. Inverted nipples are mostly congenital and are not uncommon, affecting up to 20% of men and women. It may affect one or both sides. The problem is largely cosmetic although in some women it can make breastfeeding difficult or impossible.

Some nipples are inverted at rest but will pop out with sexual, manual or cold stimulation. Others are permanently inverted. There is a variation of an inverted nipple that is referred to as ‘flat nipple’, where the nipple lies against the areola and neither protrudes nor inverts.

What causes inverted nipples?

The usual cause of nipple inversion is that the nipples are pulled inwards by short tight milk ducts. Sometimes gradual drooping of the breast tissue (ptosis) can occur faster than the ducts will stretch and the nipple inverts.

Another cause is fibrosis caused by inflammation such as a breast abscess or chronic mastitis.

Inverted nipples can also be caused by trauma, breastfeeding, breast infections or breast cancer. In some cases, patients may be born with the condition.

However, if a previously normal nipple begins a turn in without reason, it may well signal a breast tumour beneath. This should be immediately reported to your doctor.

Should I consider nipple surgery to correct my inverted nipple?

You should consider nipple surgery to correct your inverted nipple if they are causing confidence and self-esteem issues. While nipple inversion correction is often purely cosmetic, the aesthetic nature of the procedure does not undermine its value or importance.

When it comes to nipples, there are many variations and there is no right or wrong shape. Although protruding nipples are considered the aesthetic standard, there is no medical reason to correct nipple inversion, except to allow breastfeeding (though, as noted above, nipple inversion can be a sign of a medical issue).

Nipples are there to breastfeed and throughout pregnancy, all nipples tend to become more prominent. This will enable a proportion of inverted nipples to correct themselves.

There are also clever gadgets called Niplettes which when applied over the nipple gradually evert it by suction. This often works for a less severe problem.

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Should I consider inverted nipple surgery if I want to breastfeed?

If you do want to breastfeed, then Nipplettes are the first call. If the nipple will evert with stimulation, then this is encouraging. Slightly more complicated surgery can still be successful even if the nipple is permanently inverted.

If you know that you will not want to breastfeed then surgery is more straightforward as milk ducts can be cut.

How do you know if you have inverted nipples?

Nipple inversion isn’t considered a cause for concern if it has been present since childhood or puberty or if it has happened gradually over the course of several years. It can occur in pregnancy and in breastfeeding women. Women who are pregnant for the first time are particularly prone to nipple inversion.

Inverted nipples can make breastfeeding difficult as it is harder for the baby to latch on for feeding.

If a woman’s nipple suddenly changes in appearance, including sinking into the breast, then she should go to a doctor, as this can be a symptom of breast cancer.

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Can inverted nipples be fixed?

There are a number of things that purport to fix inverted nipples, although surgery is the only way guaranteed to fix the problem.

The Hoffman technique is a form of stimulation used for drawing out inverted nipples. It has been practised since the 1950s. This is not a long term solution.

Suction devices, such as cups or shells, can stimulate the nipple and make it protrude.  However, there has been no research to back up whether these devices are fully effective.

Some people claim nipple piercing can help to draw out inverted nipples. However many people find this does not work and the nipple may invert again once the body jewellery is taken out.

The most effective treatment for inverted nipples is nipple reduction surgery, which is carried out here at the Cadogan Clinic.

Nipple reduction surgery can reduce the height and width of the nipple, reshape the nipple into a more desirable form and treat size and shape asymmetries in the surrounding areola. All surgeries are able to preserve sensation and aim to restore a more balanced, pleasing chest appearance.

Nipple reduction can be carried out on its own under local anaesthesia or in combination with other procedures under general anaesthesia, such as breast reduction, breast lift, breast augmentation or mummy makeovers.

Whatever your requirements, the Cadogan Clinic can provide the leading breast experts and techniques for your treatment at our state-of-the-art facility in order to achieve your desired aesthetic and a better-proportioned nipple. Book a consultation today to discuss the best treatment option for you.


Treatments mentioned in this article

Nipple Reduction surgery - carried out on its own or combined with other procedures - reduces the height and width of the nipple, preserving sensation.

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