Is There Any Way to Correct my Grade 3 Inverted Nipples While Possibly Maintaining the Ability to Breastfeed and my Sensitivity?

Inverted nipple repair can be performed while preserving many of the ducts. We are publishing our data on our experience with over 190 nipple repairs, many of which were able to breast feed and 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 our preservation of the majority of the ducts, there is still a chance that you will not be able to breast feed after.  As you stated, you may not be able to breast feed with your inverted nipples.  However, sometimes they come out with breast feeding. If you plan on having children and breast feeding is a must you should wait to have it done until after.  Hope this helps and best of luck.

It is possible to sometimes pull out an inverted nipple and keep it protruding without cutting the milk ducts.  At other times, the milk ducts tether the nipple excessively and only transecting them can release the inversion.  If that takes place, you will lose your ability to breast feed.  It is best to be examined by a board certified plastic surgeon to see if a procedure without duct transection is possible for you.

To surgically evert the nipple, there will be some injury to the underlying milk ducts.  The degree of injury will depend on how many ligamentous attachments and ducts need to be severed to evert the nipple.  So although there is a chance you may still have functioning milk ducts, there is a real chance that you may not be able to breast feed afterwards.

Judging by your photos, you may experience difficulty breastfeeding, but it's not impossible if you get support. Surgery can be performed to correct the inversion, with minimal risk to your ability to breastfeed. During the surgery, incisions will be made in the nipple area to gently spread spread tissue fibres so that the nipple can be released. Sutures are placed to maintain this, and  a stent may also be used to support the nipple as you recover.

For grade 3 inverted nipples, the ducts likely need to be divided to give a lasting outcome and prevent recurrence. You will likely maintain sensation but will not be able to breastfeed. Consult with a surgeon to discuss options and potential risks. 

Nipple inversion is caused by fibrous smooth muscle bands that cause the nipple to retract. Many women with nipple inversion are able to breast feed.   Nipple inversion can be corrected by a relatively simple surgical procedure where a small incision is made at the base of the nipple and the bands are released using a small scissors.  Care is exercised not to cut the lactiferous ducts.  This is not always possible.  The release is much like popping a guitar string.  The only problem with doing this procedure  is the possibility of not being able to breast feed afterwards.

Thank you for your question. It is possible for women to feed with inverted nipples but you may have more difficulties than if your nipples were not inverted. While some sources say that women who have grade 3 nipple inversion cannot breastfeed I understand that breast feeding can be possible with adequate support and persistence. That said, I think it would be preferable to correct your inversion if this can be done without dividing the ducts or altering your nipple sensitivity.

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. If you wish to breast feed it is important that the technique used does not divide (cut) the ducts.

I hope this helps. Good luck!

[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.