Though it is undoubtedly the smallest area in proportion to the rest of her breast, a woman’s nipple is normally the focal point of sensuality, whose exposure strips away her modesty even if the rest of the breast is aptly covered. Moreso, it is the functional portion of the breast, where milk from the mammary glands exits her body to provide invaluable nourishment to a hungry child. Consequently, it attracts the most attention, and if the nipple is somehow deformed, it also attracts considerable embarrassment for its unfortunate owner. One of the most common deformities is that of an inverted nipple, where the nipple sinks inward instead of protruding outward normally. It is caused by the shortening of the glandular duct fibers inside the breast that are attached to the nipple, and is usually congenital. Aside from affecting self-esteem and body image, in certain cases, it may even impair a woman’s ability to breastfeed. There are three standard grades of nipple inversion to gauge the condition’s severity. In Grade 1 inversion, the nipples are inverted but can be made to protrude manually, either in cold temperatures or through stimulation. Grade 2 inversion involves nipples that are inverted more deeply and almost never protrude for longer than a few seconds. Breastfeeding may be compromised at this stage. The most severe cases are classified Grade 3, where the nipples are always inverted and the milk ducts are restricted, making breastfeeding impossible.

In its more advanced incarnations, nipple inversion can affect one or both breasts, which may result in an uneven appearance. Fortunately, correction of an inverted nipple is a relatively simple out-patient procedure, with few associated risks, and practically a 100 percent chance of success.

A patient opting for inverted nipple correction surgery is first placed under either a local or general anesthetic, or may opt for intravenous sedation. The surgery begins with an incision made at the base of then nipple while it is held in a projected state. This is followed by carefully spreading the glandular duct fibers that pull the nipple inward, so that the nipple can be extended. A blunt dissection technique is used, where the cuts are made parallel to the milk ducts, so that their function is not impaired by the surgery. The ducts can easily be seen and preserved by an experienced surgeon. Once the glandular duct fibers have been spread and the nipple is projecting outward, two sets of sutures are applied to the nipple itself, rotating around it in two semicircle patterns. A third suture is then made around the base of the nipple, like the strings of a purse. This last suture adds strength and stability to the nipple base, and helps it retain its outward projection. Surgeons performing this technique typically use dissolvable sutures so that they do not have to removed in a follow-up procedure. The sutures normally dissolve within 10 to 14 days, after which the

Afterwards, a special stent, known in common parlance as a Stevens Stent, is placed over the nipple. This stent consists of a gauze padding around the operated nipple, a traction suture inserted through the center of the nipple, and a medicine cup to provide protection, as a bandage would, without flattening or applying pressure to the nipple. The stent ensures that the nipple will retain its outward position while healing, and supports the underlying structure that keeps the nipple in place. Surgeons recommend that the stent be utilized for one to three days.

The end result of a successful nipple inversion is a patient whose self-confidence is restored, and in the cases where the milk ducts have been constricted, a woman who can now happily breastfeed her children.