Dr. Jugenburg performs inverted nipple corrections at his Royal York Hotel surgical clinic. This is a minor procedure that is performed without the need for general anesthesia and is completely painless. The procedure takes 30 minutes, after which you are able to leave immediately. There is no need to take time off from work the following day.
This information page will help you better understand inverted nipples and the corrective procedure used to repair them. If you wish to learn more, or schedule an appointment with Dr. Jugenburg to have your inverted nipples corrected, please fill out our contact form and we’ll respond to you within 1 business day.
While most women visit a plastic surgeon for enlarging or reducing the size of the breasts, many women visit due to inverted nipples. The condition is painless, but it can make the breasts look distorted, and if only one breast is involved, it can cause the breasts to look asymmetrical. It occurs in men as well, but in women it can also make breast-feeding either more challenging or not possible.
Patients with inverted nipples often feel embarrassed about the appearance of their breasts, particularly during sexual encounters. The condition is usually due to the structure of the nipple or the surrounding skin and underlying tissue. It can also be due to the milk ducts and other tissue in the nipple becoming shortened as a result of inflammation. Also, scar tissue can cause permanent inversion.
Inverted nipples are due to milk ducts that are too short to allow for the nipple to protrude out, thus tethering the nipple. This leads to the nipple being ‘pulled in’ instead of protruding. While most inverted nipples are the result of short milk ducts, they can also develops after pregnancy, when post-pregnancy loss of breast tissue results in the nipple being pulled in.
If you feel self-conscious about your inverted nipples, inverted nipple surgery can help you gain more self-confidence.
Because there are different levels of nipple inversion, Dr. Jugenburg will evaluate your specific condition during your examination. The level of nipple inversion is based on a scale of 1-3. The least severe level is often called, “shy” nipple. In this case, the nipple, while inverted, will usually respond to cold or tactile stimulation by protruding normally. Nipples may stay protruding for a while, then go back to being inverted.
In level 2, nipples remain inverted all the time. At level 3, the most severe level of nipple inversion, not even vigorous stimulation will make the nipple project at all because of severe tissue constriction or scarring.
During your consultation with Dr. Jugenburg, you will have an opportunity to discuss your goals and expectations with the doctor, and ask any relevant questions you have about your condition. The doctor will review the options that are available to you, and if surgery is required, you will have an opportunity to tour our state-of-the-art facility located in the beautiful Fairmont Royal York hotel, and meet with our caring staff that will be part of your team.
For women (or men) with the lowest levels of nipple inversion, there are some non-surgical temporary fixes available. Using suction devices that place constant pressure on the nipple provides a temporary solution, but doesn’t correct the underlying structural issues that are causing the nipples to retract.
The Niplette is a gentle instrument that uses gentle suction to draw the inverted nipple out, and remain erect.
Philips Niplette. To learn more about this device, visit: http://www.philips.ca/c/avent-baby-breastfeeding/twin-scf152_02/prd/en/
The permanent fix for inverted nipples is surgery. This is a procedure that is performed under local freezing (anesthesia) and takes about 30 minutes. The procedure is so straightforward, there is no need for general anesthesia or IV sedation. There may be some swelling and discomfort with the procedure, but there is typically very minimal recovery time required. Any discomfort will be managed with oral pain medication prescribed by Dr. Jugenburg.
During this procedure, a small incision is made under the nipple to allow the surgeon to cut the mild ducts which are tethering the nipple. This will lead to loss of the ability to breast feed. This is accomplished by making a small incision in the areola while the nipple is held in the extended position.
After the tissues are transected, several lines of dissolving sutures are placed under the skin to hold the nipple in the projected position. Once this is done, protective devices are placed over the nipples to hold them in position, and prevent them from retracting again during healing. There is a 5% risk of sutures breaking leading to a recurrence and the need for a repeat correction.
During the procedure, Dr. Jugenburg will over-correct the nipple protrusion (they will look excessively large) because we expect some settling. This is normal. Your final result will not be excessively protruding nipples. As your swelling settles over the next 2-4 weeks, your nipples will attain their intended normal shape and size.
Following the procedure, a protective bandage will be placed around the newly-protruding nipple. This protective bandage should be worn for 6 weeks and is meant to protect the nipple form external pressure the could push the nipple back inward. The sutures holding the repair together dissolve within a few weeks, and the scar is usually not noticeable, since the procedure is minimally invasive and only a small incision is made. In addition, the bumpy surface and color variations in the nipple and surrounding areola help to hide the scar.
After surgery, the results are immediately visible. And since the surgery was directed at correcting the underlying causes, the results are usually permanent. When completed, the surgery will result in a more contoured, outward-projecting appearance to the nipples.
After the surgery, you may perform non-strenuous activities such as watching television, making meals, and reading. You should avoid any physical activity that will apply pressure to the nipples (such as lying on your stomach, giving people hugs, or wearing tight fitting shirts) or stretches your breasts such as lifting your arms above your shoulders.
You should not expect significant pain following this surgery. You will have discomfort that will easily be manageable with simple pain pills. Dr. Jugenburg will provide you with a prescription for such pills. Most of our patients do not need pain pills for more than 1-2 days.
At two weeks, you will return to see Dr. Jugenburg to have your special protective dressing changed.
After the first post-operative visit, you will see Dr. Tong at 12 weeks. If your nipples have maintained their position by this time, it is unlikely they will revert and no further visits are required. Post-op photos will also be taken at these visits.