Abnormalities of the nipple or tissue underlying it are very common and relatively straight forward to treat. The most common condition is nipple inversion. In this condition the nipple instead of protruding is held inside the breast. This is caused by shortening of the milk ducts which come from the glandular tissue within the breast to emerge on the nipple.

In most cases nipple inversion is longstanding and occurs as the breasts develop. If the nipples suddenly become inverted this may signify abnormalities within the breast tissue. This should be thoroughly assessed by your doctor.

Nipple inversion occurs in approximately 10% of people and can cause significant embarrassment. It can occur on one or both sides and some patients find it difficult wearing clothes particularly thin tops or swimwear as the inversion can be visible.

Nipple inversion is classified into the following three groups:

Grade 1

The nipple can be everted and look normal. After a variable period of time if reverts to its inverted position.

Grade 2

The nipple can be everted and look normal if drawn out. However it immediately inverts when released

Grade 3

These nipples are so tethered to the underlying breast tissue that they can not be everted.

Some people with Grade 1 and 2 nipple inversion find the Nipplette device useful. This works by suction and gently pulls the nipple out to an inverted position. If suction is applied regularly the tight ducts leading to the nipple stretch allowing it to sit in a normal everted position.

Generally it is best to try the Nipplette first as if offers a simple low cost solution. For some people this solution does not work effectively and the inversion needs to be corrected with an operation

Correction of inverted nipples with surgery is surprisingly quick and simple. The procedure is performed under local anaesthetic and takes approximately 15 minutes per side. There is some mild discomfort associated with the injection of anaesthetic which last for about 10 seconds- after this the procedure is painless. The discomfort from the injection can be minimised by the application of an anaesthetic cream before the operation which numbs the area.

In the operation a small incision is made in the lower outer border of the nipple. Depending on the grade of inversion the ducts leading to the nipple are then either gently stretched or divided. If the ducts are stretched they remain intact and breast feeding is usually possible following the operation. However if the ducts require division breast feeding following the operation is not usually possible.

Once released the nipple is held in and everted position with an absorbable stitch. This is placed internally and is naturally melted away by the body during following the operation.

Following the procedure most people experience mild discomfort with most returning to work within 1-2 days.

The dressings are removed 5-7 days following the procedure and patients are encouraged to wear a soft padded bra for a further 2 weeks. Once corrected the nipples are very unlikely to become inverted again and can be treated normally.