What is the Real Deal with Fixing Inverted Nipples/ Sensitivity Loss?

An inverted nipple repair is a fairly straight forward procedure and can be done under local in the office.  You should not lose much sensation at all from the procedure.

Usually patients maintain nipple sensation following repair of inverted nipples. If there decreased sensation at first, it typically improves over time.  There is some risk of diminished sensation, but it is not common.

Dear Anne, You should not loose sensitivity to you nipples. Inverted nipple repair can be performed while preserving many of the ducts and nipple sensation. We are publishing our data on our experience with over 190 nipple repairs, many of which were able to breast feed and most maintain sensation after. We do not have the data to know just how many though as our study was a chart review and not tracking down the patients to answer these two specific questions. We plan on doing a follow up study to answer them soon. Despite the fact that most patients do preserve sensation, there is a small risk that you could have a change of sensation, either increased, decreased, complete loss of sensation. Best wishes.

Inverted nipple is usually the result of a short milk duct, that tether the nipple internally. The procedure can be done under local anesthesia at any age as long as you are not planning on breast feeding. It consist of a tiny incision at the base of the nipple allowing to release the contracted ducts and placement of a small tissue strip in throught the incision. This will prevent the duct from retracting again. You should not experience any sensitivity loss.

Inverted nipples come in two types:  the type that responds to stimulation and the type that doesn't.  The type that doesn't is a truly inverted nipple that is tethered down by small bands within it. Correcting this problem is fairly easy and can actually be done under local anesthesia in an office setting.  It involves making a small incision at the base of the nipple.  A small pair of scissors is then inserted through this incision to cut the tethering bands.  Unfortunately, the milk ducts are also cut during this process and will probably prohibit the patient from breast-feeding from that breast afterwards.  Once the bands are cut, the nipple can be everted.  A stitch is passed through the base of the nipple to maintain the eversion while the tissue heals.

 

Loss of nipple sensitivity is possible after inverted nipple repair but is uncommon.  There may be some loss of sensation temporarily in the early recovery period, but this typically resolves with no long term adverse effect.  Correction of inverted nipples is a procedure with a very high satisfaction rate for women.  I would recommend an in-person consultation with a plastic surgeon to allow for a thorough physical examination and to make more specific recommendations.
Ziyad Hammoudeh, MD

There are different degrees of inverted nipples - some nipples are always inverted while some can be encouraged to evert (poke out) with stimulation or pressure. It sounds as though your nipples do not evert at any time.

Surgical treatment of inverted nipples can definitely lead to alterations in nipple sensation and all surgery carries risks and costs. There is a suction device available (the Avent Niplette) that can treat nipple inversion without surgery. It is more likely to be effective in women who have nipples that can be encouraged to evert (with stimulation or pressure), and in women who are willing to persist using the device. It's a discreet device that can be worn during the daytime within a padded bra or at night time within a crop top.

If the non-surgical treatment does not work there are different types of surgery available for inverted nipples. If you pursue the surgical pathway but wish to try to retain as much sensation as possible I would recommend the least invasive surgical procedure combined with use of the suction device post operatively.

[Disclaimer: I have no commercial association or interest in the Avent Niplette device]

Thank you for the question.

Inverted nipples can cause functional problems for women and emotional concerns. 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. Whether a patient is a candidate for correction of inverted nipples  depends on the  extent of the problem.

Usually correction of the inverted nipples involve division  of the lactiferous (milk ducts). The risks  of the procedure include potential loss of sensation, inability to breast-feed, recurrence of the asymmetry and the potential need for further surgery.

My advice to patients go something like this...  If the nipple is permanently inverted and does not evert  with stimulation, then it is a useless nipple  when it comes to sensitivity and/or breast-feeding. In these  cases correction of inversion is indicated (because the potential gains outweigh the risks outlined above).  On the other hand, if the nipple does evert  spontaneously with  or without stimulation,  then I am more reluctant to perform the procedure given that the risks may outweigh the potential benefits.  At that point, the decision is the patient's to make after careful consideration.

I hope this helps

Anne88 from the 'Track Capital of the World.'

There are a variety of techniques for correcting inverted nipples. Most of them leave minimal scarring but do involve cutting the ducts to the nipple; therefore, breast feeding is usually out after the correction.  In my experience the majority of women keep normal sensation after the procedure and the tiny scars are almost invisible.  In most cases, the nipple does not change a lot with stimulation after nipple correction surgery and recurrence on inversion is the biggest risk. Good luck an Go Ducks.