Inverted nipple
The inverted nipple is a condition where the nipple lacks protrusion (does not point outward) and is retracted into the breast. Its causes can be
- congenital
- caused by aging
- caused by mammary duct ectasia, Paget’s disease, breast carcinoma, mastitis etc.
In the case of a tumor or infectious disease of the breast, a gynecology consult is mandatory.
Statistically, approximately 10% of women have an inverted nipple, with no other associated breast disease.
The benign causes for the lack of protrusion can be congenital, when there is a lack of nipple development during the intrauterine life or when it develops progressively in adult life. It is caused by a fibrosis of the milk ducts which connection the mammary gland to the exterior.
Although there is a great variety in shape, color, protrusion and size of the nipple, the average projection is statistically of 0.9 cm.
Surgical treatment
Depending on how easily the nipple may be protracted, there are three degrees of inverted nipple, based on which the surgical treatment is established.
The surgery consists of the percutaneous release of the fibrosis and the positioning of a piercing to maintain the nipple protrusion. The procedure is performed under local anesthesia, without incisions, and the recovery is immediate. The pierce should be kept in place for at least 6 weeks and it is necessary to clean the area with antiseptic solutions.
In more complicated cases, when the release of the nipple cannot be achieved only by the percutaneous sectioning of the fibrosis, its protrusion will be restored using different local reconstruction techniques (flaps). In this case, the intervention is performed in the operating room, using local anesthetics, sedation or general anesthesia. There is no universally valid surgical technique. Each individual is different, and the treatment is personalized according to the degree of retraction.
Can I still breastfeed after this procedure?
During the surgery that section the fibrotic bands (located immediately below the nipple), it is impossible to differentiate these strips from the normal milk ducts. During the procedure, some of the ducts are severed, and their healing does not restore their connectivity. This may interfere with breastfeeding in the future.
If you are planning a pregnancy and breastfeeding, it is recommended to postpone the intervention until the end of the breastfeeding period. Sometimes during pregnancy and after birth, due to the increase in breast volume, the nipple can regain its protrusion.
Recovery
Recovery is generally fast. When the correction is done only through piercing to maintain the protrusion, normal activity can be resumed immediately after the intervention. You need to use antiseptic solutions to daily clean the nipple / nipples and apply a sterile dressing. Wear a lightweight bra / bustier that won’t squeeze your pierce. You can take a shower in the evening of the intervention.
For the procedure that uses local flaps, when there are suture wires, the effort you put into your recovery and care is greater. Local hygiene and dressing are very important, as well as taking a short break from intense physical activities (aerobics, fitness). You can resume normal activity on the second day after the surgery. Local discomfort is greater in the case of this intervention, so you will be prescribed pain medication.
