Inverted, retracted or invaginated nipples characterize the cases in which the nipples are turned towards the inside of the chest, that is, when they do not project outwards. This is a congenital alteration that occurs in about 3% of the world’s population.

Despite being a pathology associated mostly with women, it can also appear in men. Most of the time it is caused by the weakness of a muscular sphincter present in the areola or by the presence of very short galactophores that pull the nipple, these channels that are responsible for conducting milk from the mammary gland to the nipple.

There are at least three degrees of nipple inversion. To identify the degree of inversion and see if there is a relationship with any clinical condition, the doctor may perform some stimulation tests. The degrees of nipple inversion are:

Grade I – when, after stimulation, the output of the nipples and their projection for some time are recorded;
Grade II – when after stimulation it is possible to project the nipples, but for a short time.
Grade III – when even after stimulation the nipples are not projected. In these cases, nipple inversion may be due to fibrosis or atrophy of the terminal region of the mammary ducts.

About 96% of cases are Grade I and II. In all three cases, the most indicated solution is surgery, given that alternative measures, such as vacuum pumps or pulling exercises, are ineffective.

The surgery has the function of “freeing” the nipples from the fibrous bands that hold them in order to allow their projection. The surgical procedure consists of cutting the galactophores as well as the muscles that retract the nipples. A specific suture is also made in that location which will remain for a month, at which point it will be removed. The sutures are inside the areola and at the base of the nipple, so after the surgery there is no visible scar.

It is important to mention that in the past the techniques used to make this correction could compromise breastfeeding. However, nowadays, with the development of new surgical techniques, it is possible to correct inverted nipples without interfering with this function.

The inverted nipple correction surgery is performed under local anesthesia or sedation and lasts approximately 30 minutes. She does not need hospitalization and, as such, she is discharged on the same day, going home with a pad and a containment bra.

For the surgery it is necessary to carry out an ultrasound and a mammogram and it is recommended to moisturize the nipples daily one month before the surgery. The stitches are removed after one month.