If Had an Unsuccessful Nipple Inversion Correction Surgery Twice, Will Implants Help?

Question

I've had 2 nipple correction surgeries, one in hospital under general anesthesia and then again in office w a local in office procedure, both unsuccessful. Both nipples are grade III inverted. I've consulted a second doctor and he looked over records and confirmed everything was done by the book and should have worked. He was at a loss - would implants help correct this since the fibers holding the nipple have been severed? Very insecure and desperate, help!

Ronald J. Edelson, MD · Answer

I have had cases where the insertion of implants has corrected inverted nipples, but there is no assurance that this would work in your particular case. It may be worth getting a second opinion to see if there may be a different method for correcting the problem.

Ronald Schuster, MD · Answer

I'm sorry to hear that your surgery was unsuccessful. Grade 3 nipple inversion is the most severe. Full correction can sometimes require cutting the ducts which of course we prefer not to do if possible. I perform the surgery using an endoscope which makes it a little easier to see the and protect the ducts while dividing the fibrous tissue that inverts the nipple. in addition i use a dermal graft and purse string suture at the base of the nipple. this combination is usually successful. implants will not help as it only adds pressure from underneath the breast and will not push the nipple out.

Steve Laverson, MD, FACS · Answer

Re-do the nipple inversion surgery with transection of ducts, purse string around nipple, and post surgical splinting with amputated syringe holding suture that maintains nipple eversion. Implants may add security to the eversion and help secure the result as well, but will not evert the nipples without successful manipulation of ductal and cutaneous nipple elements.

John J. Corey, MD · Answer

It doesn't sound like to me that just implants alone will help. This is a difficult problem to correct at times and I too feel that transection of the ducts is needed. I also run a suture criss-crossing the base of the nipple in both directions and another one as a purse string around the edge and then suspend it from a suture for 5-7 days! But there are many ways.

Howard Webster, MBBS (Hons), FRACS · Answer

There are 2 kinds of nipple inversion correction procedures. There is also one non surgical option (the nipplette) which has a very low success rate.

	The surgical procedures can be divided into those which DO NOT cut the ducts.  The ducts connect the milk producing lobules to the nipple and shortness of them for a variety of reasons causes nipple inversion.  Whatever techniques are used that DON'T cut the ducts, they have a low success rate but do preserve your ability to breast feed in the future.

	If a DUCT CUTTING technique is used, the success rate should be close to 100%. But you might not be able to breast feed, you may have a higher risk of mastitis (not a very increased risk though), and your nipple sensation might be altered.

	There is a lot we don't know about you: Age, breast size, possibilities of future pregnancies, whether your nipple sensation is important to you for example.  But if you were prepared to risk future breast feeding and an alteration in nipple sensation in order to achieve nipple eversion, then it can certainly be done with a high degree of success, under local anaesthesia as an office procedure.

	Given your two previous procedures, I'd be pretty sure that implants are not going to evert your nipples.

If Had an Unsuccessful Nipple Inversion Correction Surgery Twice, Will Implants Help?

Answers (5)