Inverted nipples are most commonly due to shortened milk ducts, either as a congenital problem (something you are born with), as a result of surgery on the nipples or one that develops over time for no obvious reason.
To correct this problem, the ducts to the nipple need to be cut. At the same time the nipple needs to be supported and the base of the nipple secured to keep the duct ends separated to try and prevent the ducts from reconnecting. To support the nipple, I use the end of a small syringe as a stent, which is left on for five to seven days. After this is removed, it is recommended that the nipple be protected by wrapping gauze around it so that pressure is not applied to it when wearing a bra.
As a result of cutting the ducts to the nipple, it is very unlikely that one would be able to breastfeed after a nipple inversion correction procedure. However, it is very common for patients with inverted nipples to not be able to breastfeed anyway. Some patients who have inverted nipples and are able to breastfeed find that their condition is partially or completely corrected as a result of breastfeeding.
Performing this surgery at the same time as inserting breast implants in not generally an issue and is commonly done. There is some evidence to suggest that operating on the nipples can increase the risk of breast implant infection. For this reason, the implants are inserted first and these incisions are closed prior to performing the nipple correction surgery. Performing these procedures simultaneously does not generally prolong the recovery period for breast implant surgery.
Reductions and Lifts
It can be a problem, however, to perform nipple correction surgery at the same time as a breast reduction or breast lift procedure. This is because the process of repositioning the nipple and areola that occurs at the time of a breast reduction or lift results in some loss of blood supply to the nipple area. Severing the milk ducts to the nipple to correct the inversion also reduces blood supply to the nipple; the combination of both procedures done at the same time could result in critical loss of blood supply to the nipple resulting in skin slough of the nipple or areola or both. Permanent scarring, color changes or nipple deformity could be the result.
It is not a problem to perform nipple inversion correction on a patient who has had a lift or reduction previously or is going to have one of these surgeries in the future; just don’t do them at the same time.
If you choose to have the procedures done separately, the inverted nipple correction surgery can be done as a relatively simple surgery in an office operating room using just local anesthesia. However, it certainly makes sense to recover from both procedures at the same time.