Inverted nipples and breast augmentation

An inverted nipple may be congenital or acquired from malignancies, infection or surgical deformation. Congenital forms have as much as a 50% familial tendency. The last 3 causes listed result in nipple inversion from scar tissue contraction. The congenital form has 3 components:
1. scar like bands of tissue & underdeveloped breast milk ducts that tether the nipple
2. lack of smooth muscle fibers that normally prevent nipple inversion
3. thinned deeper tissues just beneath the nipple
There are a number of different plastic surgery procedures to evert the nipple. I prefer a technique performed under local anesthesia that involves placing a traction suture to pull the nipple out. A flattened needle is then used to cut the scar bands that keep the nipple retracted. The traction suture is then taped to the skin for 8 to 12 days until the nipple heals in its new position. The patient returns to the office at days 4, 8 & 12 after the procedure. Despite surgical eversion one can still have difficulty breast feeding because of the underlying problem. Because a needle is used the amount of visible skin scar is minimal. A breast augmentation alone will not fix this because it does nothing to the scar like bands of tissue or smooth muscle of the nipple complex.I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship in order to know if this assessment is valid.

Thank you for your question. Breast augmentation can help, but it is difficult to tell for sure. I would recommend an in-person consultation with a board certified plastic surgeon. 

Great question !  I have had patients with grade 1 inverted nipples which were corrected simply by putting in breast implants.  I would recommend that you have the breast augmentation alone, and see whether the nipples correct.  If they don’t, you can have them corrected with a simple procedure under local anaesthesia that leaves virtually no scar.

Yes I have seen Grade I inverted nipples get corrected with Breast Augmentation alone.  If you are a grade I and considering breast implant surgery, then I would likely say to have the augmentation surgery and see if things correct, if not then the correction may be performed in the office under local anesthesia.  This way you may be fine after the augmentation and avoid any additional surgery.Hope that helps.

Dear Realme0108,it is hard to tell for sure without an examination. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Everting nipples (if accepting of numbness and not breast feeding) is easily done in the office under local and takes less than 30 min.  So get the procedure first and then decide later if you still need the nipple everted.

I find that breast augmentation usually does not solve an inverted nipple. The nipple may appear resolved shortly after surgery due to swelling and inflammation, but as the tissues relax to a more normal state, the nipple often times retracts. I address nipple retraction at the same time as the breast augmentation through a minimally invasive technique to help bring the nipple out to a normal projection. The scars are not noticeable since they are tiny similar to needle pokes and at the junction crease of the nipple base and areola. There is a risk of reduced milk secretion or sensation from this procedure however it is very low with a modified technique. Patients often times have more sensitive nipples immediately after surgery which returns to normal over the course of several months. Hope this helps!Johnson C. Lee, MD
Board-Certified Plastic Surgeon
IG: @drjohnsonlee

An inverted nipple may be improved by an augmentation, with an implant pushing upward upon the nipple. However, an inverted nipple is caused by shortened or scarred down lactiferous ducts from your breast gland to the tip of the nipple. Chances are that without surgically releasing these shortened ducts, your nipples will removing inverted. Surgical correction is quite simple and can be easily preformed at the time of your BA, or even after under local anesthesia. 

Inverted nipples generally do not correct with an augmentation, they will likely stay the same.  There are procedures for correcting inverted nipples which are separate from an augmentation.  It would be best to address the inverted nipples after child bearing to avoid milk duct damage.

Inverted nipples can cause functional and body image problems for women. An inverted nipple can look flat or a slit like depression or hole at the normal nipple location. There are different degrees of inverted nipples possible.  Usually correction of the inverted nipples involve division  of the lactiferous (milk ducts). Risks of the procedure include potential loss of sensation, inability to breast-feed, recurrence of the inversion and the potential need for further surgery. The procedure can be performed at the time of breast augmentation surgery only. Sometimes, breast augmentation surgery alone will suffice (without the need for additional maneuvers to evert the nipples).  
 In my practice, if a patient's inverted nipple everts spontaneously or with manipulation, I generally do not advise surgical correction at the time of breast augmentation surgery; these patients often experience the eversion of the nipples with breast augmentation surgery alone. On the other, if a patient's nipples are permanently inverted, regardless of temperature change or stimulation, then I will correct the inversion at the time of breast augmentation surgery.  This decision-making (and advice) boils down to careful consideration of pros/cons  and possible risks/complications.
 
 My best advice: select your plastic surgeon carefully. Make sure that he/she has significant experience achieving the types of outcomes you will be pleased with.   Your plastic surgeon, based on your history and physical examination, will be your best resource for accurate assessment and advice.
 Best wishes.