Before and after bilateral inverted nipple repair in a 24 year old woman. Her inverted nipples made her feel self-conscious. Her left side was more severely inverted than her right. She wanted both her nipples to be out and to be symmetric!
An inverted nipple correction was performed in the office under local anesthesia. Step by step details are shown below, including the stitch that helped to pull the hidden nipple out and keep it everted for the first week, the donut splint and the waterproof postoperative dressing.
After preoperative photos were taken and local anesthesia was injected, a small incision was made in the undersurface of each nipple at their base. The nipple was pulled out with a “marionette stitch” that was left in place for one week after surgery. Tight bands that were pulling the nipples downwards were divided but an intact nerve supply and ductal supply was maintained to the nipple to best enable future breast feeding and erogenous sensation.
A “donut splint” made out of soft sticky medical foam was placed over the nipple repair afterwards and a waterproof dressing overtop that is like clear plastic. The patient was allowed to shower the next day and to return to work in 2 days. Pain medication was only required for the first 24 hours – Tylenol was enough after that. The marionette stitch was removed at the first postoperative visit, one week later. The other sutures were dissolving and slowly reabsorbed on their own.
Follow up photos are shown one month after surgery. She is wearing silicone nipple shields over her nipples to conceal them when she does not wear a bra. She no longer feels self-conscious and is very happy to undress at the gym or in front of intimate partners.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
