Inverted nipple correction in London

An inverted nipple is one that sits flat or is pulled inwards instead of pointing outwards. It can affect one or both nipples, in women and in men. It is common and, when it has been present since puberty, is usually harmless. Estimates vary; a 2020 review put it at around 2% to 10% of women.

Long-standing inversion is usually caused by milk ducts that are shorter than the surrounding tissue, together with tight fibrous bands beneath the nipple. It can also develop after breastfeeding, infection, duct changes that come with age, or breast surgery.

A new inverted nipple needs checking first

If a nipple has recently turned inwards and does not come back out, see your GP before considering any cosmetic treatment. Most new inversion has a benign cause, such as duct changes with age, but occasionally it is a sign of breast cancer pulling on the ducts. This is especially important if there is a lump, discharge, skin dimpling or a change on one side only. We will ask about this at consultation and may recommend assessment at a breast clinic before any procedure.

Grades of nipple inversion

Surgeons commonly grade inversion from 1 to 3, following a system described by Han and Hong in 1999. The grade reflects how tight the tissue under the nipple is, and guides both treatment and what it means for breastfeeding.

Inverted nipple correction may suit adults, women and men, whose nipples have been inverted for a long time and who would like them to project. Suitability, and the right technique, is decided at consultation with your operating surgeon.

People choose correction for different reasons:

• self-consciousness about how the nipples look;
• difficulty keeping the nipple clean, with irritation or recurrent infection in the fold;
• a difference between the two sides;
• hoping to make breastfeeding easier in future, in milder grades.

Things to think about first:

• Breastfeeding plans: if you hope to breastfeed, tell your surgeon. Duct-preserving techniques are preferred, but no technique can promise breastfeeding afterwards.
• Recent change: a new inversion needs medical assessment before correction.
• Other breast surgery: if you are planning a breast reduction, uplift or augmentation, the nipple can often be corrected at the same time.
• Age: cosmetic procedures are for people aged 18 and over.

The NHS does not usually offer surgery for inverted nipples for cosmetic reasons.

The technique is chosen for the grade of inversion, and for whether you want to preserve the milk ducts. Some people with grade 1 inversion do not need surgery at all.

Inverted nipple correction usually takes 30–60 minutes for both sides under local anaesthetic, and you go home the same day.

Consultation

Your surgeon will ask how long the nipples have been inverted, about any change, discharge or lump, and about your plans for breastfeeding. They will examine each nipple and grade it, and explain which technique they recommend and why. You then have at least 14 days to reflect before you give consent to the surgeon who will operate; further consultations are always available.

On the day

1. The nipple and areola are cleaned and numbed with local anaesthetic injections. You feel the injections, then pressure but not sharp pain.
2. A small incision is made at the base of the nipple, where it meets the areola.
3. Tight bands are released, and in grade 3 some ducts may be divided, as agreed beforehand.
4. The nipple is held out with a deep supporting stitch and, if needed, a small tissue flap.
5. The skin is closed with fine stitches, and a protective dressing is applied. Some surgeons use a small shield or cap to protect the nipple for the first days.

You can usually eat and drink normally and go home soon afterwards. It is sensible to have someone accompany you.

1. Days 1–3

   Mild soreness and swelling, usually eased with paracetamol. Keep dressings clean and dry. Wear a soft, non-wired bra or a loose top. Avoid pressing on the nipples.

2. Week 1

   Most people are back at desk work. First wound check. Showering is usually possible after 48 hours, keeping the area dry afterwards.

3. Weeks 2–3

   Stitches, if not dissolving, are removed. Avoid tight tops, chest-pressing exercise and contact sports. Lower-body exercise can resume.

4. Weeks 3–6

   Upper-body exercise and swimming usually resume once the wounds are healed, as your surgeon advises. The nipple may look slightly over-projected or swollen at first.

5. 3–6 months

   Swelling settles and the nipple reaches a stable shape. Tiny scars at the nipple base fade and are usually hard to see.

Most corrections give a lasting improvement in nipple projection. In a 2020 review of 33 studies covering 3,369 cases, the overall success rate was 88.6% and the reported recurrence rate was 3.9%, although the studies used different techniques and follow-up periods, so individual results vary.

Recurrence is more likely in grade 3 inversion and when ducts are preserved. NHS inform advises that surgery is not usually recommended purely for appearance because inversion often comes back, although published specialist series report lower recurrence rates. Your surgeon will explain the balance between preserving ducts and reducing the chance of recurrence for your grade.

Scars are small, at the junction of the nipple and areola, and usually fade well. Pregnancy and breastfeeding can change the nipples again. If you are planning a family, discuss timing with your surgeon.

Where one nipple is corrected and the other is not, or the two were different grades, some difference in projection between the sides is common. A small adjustment can be made later if needed.

You do not need to have treatment for a long-standing inverted nipple. If it does not bother you, leaving it is a reasonable choice.

• Suction devices: may help grade 1 and some grade 2 nipples, with effort and uncertain long-term results.
• Breastfeeding support: if your main concern is feeding a baby, a midwife, health visitor or lactation consultant can help with positioning and devices such as nipple shields. NHS inform notes that you can usually still breastfeed with an inverted nipple.
• Piercing: some people try nipple piercing to hold the nipple out, but it carries risks of infection and duct damage and is not a recommended medical treatment.

Inverted nipples in men

Men can have inverted nipples too, sometimes alongside enlarged breast tissue (gynaecomastia). In men, the correction is similar and breastfeeding is not a consideration, so a duct-dividing technique may be chosen for a more reliable result. A new inversion in a man should be checked by a GP, as male breast cancer, although rare, can present this way. If you also have enlarged chest tissue, see gynaecomastia surgery.

At iQonic, inverted nipple correction costs £2,200 for one nipple and £3,000 for both.

If the correction is combined with another breast procedure, such as a nipple reduction, breast reduction or uplift or breast augmentation, your quote will reflect the combined operation.

Your written quote is valid for three months. For payment options see our pricing and finance page, and you can book a consultation at 15 Harley Street, London.

Your consultation is with the consultant who would operate. Check any surgeon on the GMC register.