Are my nipples inverted? (Photo)

Question

My nipples have always been somewhat more of lumps that harden when cold or stimulated. My whole life I thought this was normal, until a friend said her gyno told her she had inverted nipples, and we determined mine were similar. I'm very bothered by this because I can't go braless without looking like I have two lumps instead of regular protruding nipples. (Also sorry if the pictures come out upside down)

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Thank you for your question and attached pictures. With respect to whether you have inverted nipples - looking at the first picture I would say no. The third picture shows a slight indentation on the nipples but not really totally inverted so I would not really class this as inverted - but assessing these in a photograph and in a clinic consult would really determine whether they are truly inverted or not. There are 3 levels of inversion generally - classed in three types - type 1 - which on pressure can pop out and stay out; type 2 which can pop out but then retract and invert; and type 3 - those that remain inverted. Looking at your nipple pictures I do not think you have inverted nipples as the outer aspect of the nipple is quite well defined and the overall shape and symmetry is in fitting with the rest of the breast. In terms of treatment for this - I don t feel you would benefit from surgery to correct this/ or the use of pumps to pull out the nipple. you would have unnecessary scarring around an area that is essentially normal. Having carried out many inverted nipple corrections - I dont think you would see any significant benefit from what you have currently. I do think you should go back to believing what you did your whole life and I do feel you have normal looking nipples. You friend may well have inverted nipples but with the shape and projection and overall look of your nipples, I would not consider this the case for you. I hope that this may help answer your questions and alleviate some of your worries. If you would like any further information or would like any more advise you can contact me or my colleague Mr Rohit Seth, and we will be glad to advise.Best wishes

Jonathan Hall, MD · Answer

Inverted nipples are caused by the nipple ducts being relatively too short and pulling down on the nipple like a parachute cord.  There are different classifications based on whether the nipple can be easily stretched out manually or if it is tightly fixed down.  You do not appear to have nipple inversion in the first photos but a mild nipple inversion is seen in the second group of photos.  This can be corrected with surgery- I prefer a micro-incision technique under local anesthesia where a tiny knife blade shaped like a needle is used to release the overly tight nipple ducts and then the nipple is held out to length with a suture tied over a special cap for 1 week and then protected with gauze pads with a hole cut out for 5 more weeks.  An alternative was reported in the Journal of Plastic Surgery where a barbell nipple piercing can be placed across the nipple instead to stretch the nipple ducts. Your nipple inversion is mild, but if it bothers you then it is worth discussing it with a board certified plastic surgeon.  Good luck!

Gregory Pastrick, MD · Answer

You definitely do not have inverted nipples as they are protruding out from the breast or forward, which is normal.  Inverted nipples protrude inward which leaves a crease or indentation where the nipple is. In some women the nipple may protrude inward but can protrude outward when stimulated or cold and this is still considered an inverted nipple. So unless your photos were taken under these circumstances and then retract inward, you don't have inverted nipples. Hope that helps.

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