Unlike some physical abnormalities related to the breast, an inverted nipple does not pose any risks to the patient's health. This problem is strictly cosmetic in the majority of cases. However, it can present women with problems when it comes to breastfeeding children.
A combination of developments in the body can lead to an inverted nipple. In most cases, the milk ducts that are present in the tissue become shortened. There can also be fibrous tissue between the ducts that is preventing the nipple from everting. In more severe cases, patients may also suffer from a lack of supportive soft tissue that normally resides just below the nipple. Because the severity of the condition can vary, surgeons have classified inverted nipples with three grades of severity.
Grades of Inverted Nipple Severity
The first grade for inverted nipples shows signs of minimal fibrosis, and the supportive soft tissue remains present beneath the nipple. The nipple can easily be everted. Doctors can typically deal with the issue simply by pulling out the nipple using a suction-based device. The nipple may be temporarily pierced in order to keep it in place until the healing is complete. However, piercing is not always a necessary step. For many patients, the nipple stays everted for long periods of time without any form of traction taking place. These types of non-surgical methods are not successful in all cases. In some instances, doctors perform a simple surgical procedure that involves placing a purse-string suture around the lower portion of the nipple, leaving all ducts intact.
The second grade of nipple inversion cannot be everted as easilyas in Grade I. Most patients have some level of fibrosis present while the ducts are shortened as well. The corrective procedure may involve dividing the ducts at any point to make changes. The corrective surgery divides the fibrous tissue that is responsible for tethering while still preserving the milk ducts.
The third and final grade of severity results in a nipple that cannot be everted. In these cases, the milk ducts are extremely contracted, and there is a high level of fibrosis that is present in the tissue. There is also typically a deficiency in the supportive soft tissue that resides under the nipple. Corrective surgery requires dividing all of the tissue responsible for tethering as well as the milk ducts. Although this surgery is successful in correcting the issue, patients are unable to breast feed while also face the possibility of losing sensation in the nipple.
Correcting Inverted Nipples
All of the above corrective procedures are conducted using local anesthesia, and the recovery process for the patient is basic. The dressings used for the first 5 days are somewhat bulky and loose clothing needs to be worn to camouflage the dressings. This dressing includes a plastic dome. This device is meant to protect the nipple while preventing it from experiencing extreme pressure for a period of one to two weeks. The discomfort that patients experience is generally mild.
In most patients the correction is maintained, however in some patient inversion recurs and a revision is necessary.