Inverted Nipple Surgery in Toronto

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Inverted nipples are when your nipples point inward or lie flat instead of sticking out. This happens in the areola, the area around the nipple. Some people are born with them, while others might experience this condition as they grow older.

Inverted nipples are uncommon, with about 10 to 20% of women having them naturally. Having inverted nipples usually doesn't affect one's health, how they feel, or even breastfeeding for most people. So, it's often not something to worry about, and there's no medical need to fix it. But if you want to address it, there are ways to make the nipples protrude more, like simple stimulation or, for a long-term solution, surgery for cosmetic reasons.

Inverted nipples are not unusual. In fact, inverted nipples are included among the types of nipples. However, it could be a sign of something more severe, so it's important to visit your doctor if your nipple recently became inverted.

At TMSC, our surgeons are Royal College-certified, with over 10 years of experience helping people improve their appearance and confidence. We provide consultations to understand your concerns and expectations, as well as educate you on the risks and benefits of surgery. Our goal is to help you achieve your desired results while ensuring your safety and comfort throughout the process.

Have you experienced inverted nipples recently?

Both men and women can have inverted nipples, which means one or both nipples might be flat or look like they're pulled inward. This is sometimes called "retracted nipples." If you were born with inverted nipples, it's generally not a sign of any health issues. However, if your nipples become inverted later in life, it might be something to pay attention to.

When you visit our surgeons for an inverted nipple surgery consultation, they'll talk to you about your overall health, your family's health history, and any other signs you might have noticed. They'll take a close look to understand your situation better and advise you on whether you should consider further checks or assessments.

Did you know that inverted nipples are included among common nipple types? Inverted nipples indent more than they protrude. At TMSC, our board-certified plastic surgeons perform inverted nipple correction in Toronto. This way, you can feel more confident and comfortable in your own skin. Our team works with you to determine the best approach for your unique situation, whether it's a simple stimulation technique or surgery.

Did you know that inverted nipples are included among common nipple types? Inverted nipples indent more than they protrude. At TMSC, our board certified plastic surgeons perform the inverted nipple correction treatment to help our patients feel more comfortable and confident.

Woman covering her breasts
inverted nipple

Inverted Nipple Symptoms

Inverted nipples are essentially nipples that either retreat inward or lay flat against the areola rather than protruding outwards. The severity of this condition is determined by three different grades, which consider the level of inversion and its probable impact on breastfeeding.

  • Grade 1: This is the mildest form of inverted nipples, where the nipple can be easily coaxed out by gently pressing your thumb and index finger on the areola. Once drawn out, the nipple tends to stay protruded for a certain duration. Breastfeeding is typically possible in this grade and the action itself, along with stimulation and a drop in temperature, may aid in drawing out the nipple.
  • Grade 2: In this grade, while it is possible to manually draw out the nipple using the method mentioned in Grade 1, it tends to retract quickly once released. It may also prove more challenging to coax out compared to Grade 1 inversion. There might be some difficulty encountered during breastfeeding.
  • Grade 3: This is the most severe form of inverted nipples, where it is not possible to manually draw out the nipple and breastfeeding is not feasible.
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Inverted nipples from birth are often due to the way the nipple tissue sticks tightly to the tissue underneath. However, having inverted nipples is not unusual, with an estimated 10 to 20 percent of women having this naturally. Sometimes, when it's cold or with some stimulation, nipples might protrude, but usually, they're tucked in. This doesn't mean you can't breastfeed, and there's no medical reason to fix them, but some people choose to for how it looks.

There are quite a few reasons why nipples might turn inward:

  • Aging: As women hit their 30s, it's not unusual to see some changes in their nipples, which might pull back a bit. This is more noticeable as they approach menopause, due to changes in the breast like the milk ducts pulling back.
  • After breastfeeding or surgery: Nipples might draw inward after you've breastfed or if you've had surgery there, possibly because of scarring or damage.
  • Being born that way: If your nipples have always been flat or inverted since you were young, it might be that the base of the nipple or the milk ducts didn't fully develop.
  • Injury
  • Mammary duct ectasia
  • Bacterial infections, like mastitis
  • Abscess under the areola

If your nipples are inverted, it's a good idea to talk to a surgeon who knows a lot about this, just to check everything's okay. While it's usually not a big deal, sometimes it can be a sign of something else going on. Our certified surgeons can help you understand what's happening and talk about what you might want to do about it.

An inverted/retracted nipple
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At TMSC, we understand that making changes to your body requires careful thought and planning. Our surgeons take the time to answer all of your questions or concerns about pre-planning, the procedure itself, as well as the recovery period. We ensure every patient has ample time to discuss their unique situation, goals, concerns, and special considerations about their inverted nipple treatment in Toronto.

In most cases, nipple eversion is a very straightforward procedure known as the release and secure technique, a same-day procedure performed while the patient is awake with local anesthesia. During this simple surgery, your surgeon will make a small incision along the base of the nipple. This frees the milk ducts from the tissue that surrounds them. As a result, they don’t continue to pull your nipple inwards. The new protruding shape of the nipple is positioned optimally before being secured via sutures. The nipple then heals.

Post-surgery, nipple sensation may increase or decrease. Furthermore, patients will likely lose the ability to breastfeed through their respective breasts. However, any scars or marks left by the incision(s) are as discreet as possible. We always take special care to minimize scarring during every surgery. During post-operative visits, your surgeon will guide you through healing well. Once healing is complete, any signs of surgery will be virtually invisible to others.

A diagram showing a normal and an inverted nipple side by side
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Does the areola complex have a regular size or not?

There are different areola sizes. Usually, plastic surgeons set the areola size to around 38-48mm. Our surgeons are board-certified plastic surgeons and have more than 15,000 combined surgeries under their belt. They take into account the patient’s preference as well as aesthetics before making this decision.

What factor decides the size of the nipple/areola complex during a nipple reduction or breast reduction surgery?

As discussed, the usual areola diameter that most surgeons suggest is between 38 mm and 48 mm. This size usually matches the overall breast mound. But if our surgeon finds out that the area is already smaller than 48mm, they save the entire areola area. If the areola is larger than the preferred size, he generally trims away the excess area. But they always take aesthetics and patients’ preferences into account.

Is the size of the nipple changed during breast surgery?

During breast surgery, the size and shape of the nipple usually stay the same. But that is not always the case. Depending on what you want and what is aesthetically pleasing, our surgeon might suggest a change.

How is an areola reduction made?

Our surgeon starts by drawing a circle around the areola with the nipple as the center. Once that is done, they make an incision on this circular line. Our surgeon then removes all the areola tissues outside the line to place the new areola there.

How is a nipple revision done?

Thanks to technology, there are various techniques that our surgeon uses for nipple revision surgery. The technique that they choose usually depends on the length and the diameters of the nipples. Our surgeon usually removes a portion of the nipple skin while ensuring that the milk ducts and nerves are intact.

Can the Areola stretch after breast surgery? How can our surgeon fix that?

Widening the scar is a possibility with any surgery, and the same is true for nipple revision. Usually, our surgeon performs the surgery so that the periareolar scars blend in with the natural contrast of the breast and areola colours. A revision can be performed if there is a widening or stretching of the scar. Our surgeon will discuss all of this with you during the initial consultation. If necessary, they will call you for follow-up visits to minutely examine the scars and suggest what to do about them. If they find it necessary, they could even place a permanent “purse-string” stitch around the areola, which keeps the breast skin around the areola from stretching. But this is rarely needed.

Does the patient have any input into the size and placement of the nipple/areola complex?

Yes, our surgeon ensures that they are available for the patient in every consultation and follow-up visit. They also consider the patient’s preferences and aesthetics when deciding the size and placement of the nipple or the areola.

What causes a stretched or widened nipple/ areola complex?

Multiple factors might affect the widening of the nipple/areola complex. It could be due to genetics, the weight of the breast, elasticity of the skin, age, and more.

Is it better to place the nipple/areola complex facing forward or a little to the side?

Generally, our surgeon places the nipple/areola complex in a forward-facing position. But they make sure that it is also centered on the breast mound and conforms to the breast shape.

Does your nipple/areola complex always lose colour after surgery?

Different people react to the surgery in different ways. Mostly, the colour of the nipple/areola complex remains the same, but in some cases, lightening or darkening of the pigments has been observed.

How common is loss of sensation after nipple revision surgery?

Most women are completely numb right after the surgery. Some are partially numb. But in most cases, the sensations come back after a little while. Our surgeon will thoroughly examine you after the surgery and recommend what’s best. If you don’t have any sensation after the surgery, you can discuss it with the surgeon during the follow-ups. Unlike most plastic surgeons who are only present for the surgery, all the consultations and follow-ups are performed by our surgeons, and they are always present for every one of your appointments.

How common is nipple hypersensitivity after surgery?

Nipple hypersensitivity is not as common as numbness. But it does sometimes happen. Usually, it is resolved over time. If you are feeling it, make sure you keep your nipples/areolas moisturized and protected. When you come to our office for a consultation, one of our surgeons will take you through the entire process during your follow-up visits. They will also give you advice on how to desensitize the area.

Our surgeons have helped over 15,000 patients thus far. Today, they complete roughly 600 breast surgery cases per year. They not only perform the most leading-edge plastic surgery techniques but also teach other surgeons as well.

Our board-certified plastic surgeons will meet with you to listen to your concerns, examine you, and recommend a plan to help you reach your body goals.

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