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Inverted Nipple – Causes, Repair, Surgery Cost, Treatment

Written by Dr.Mary

What are the causes of Inverted nipples?

Nipples as well as areola may vary in shape, coloration as well as size. “Normal” nipples are ones you were born with – puffy, sky prominent and flat. Nipples can change for many reasons especially because of hormonal changes, during pregnancy, puberty as well as breastfeeding. A woman should know what her nipples are normally and remember to examine them as a portion of the monthly breast self-exam.

Nipples, just like other parts of our bodies, change as we age, grow as well as mature. It is advisable to know what is normal for your nipples. Watch out for any nipple discharge, blisters, unusual pain or lumps.

Inverted Nipple Causes

Nipple changes or tenderness can be caused by:

  • Fungal or bacterial infections
  • Injury to or friction over the nipple area
  • Dry skin in the areolar region – (the darker area surrounding the nipple)
  • Paget’s disease

The chances of discharges from the nipple increase with age. It is common in some women who have had one pregnancy or also during the final weeks of pregnancy.

A discharge which is milky is very rare in women as well as men, but it can occur. When it does occur in men or women who have never been pregnant, then it is likely to be the result of an underlying disease. But, discharge of the nipple has many diverse causes that aren’t breast cancer, including:

  • A small, noncancerous growth in the breast known as intraductal papilloma
  • A tumor in the brain known as a prolactinoma or microadenoma
  • Injury to the breast or chest wall causing milky discharge
  • Breast abscess located underneath the areola – common in women during breast-feeding
  • Pregnancy, normally during the 2nd trimester
  • Severe hypothyroidism
  • Widening of milk ducts referred to as ductal ectasia, and usually not a problem with cancer
  • Use of certain drugs, including birth control pills, cimetidine, methyldopa, metoclopramide, reserpine, phenothiazines, verapamil or tricyclic antidepressants
  • “Witch’s milk” which is a term used to describe nipple discharge in a newborn. This discharge is cause by hormones from the mother before birth, and normally disappear within 2 weeks

Inversion of the nipple is a condition one is normally born with. Nipple retraction can be caused by duct ectasia, infections in the milk duct, breast cancer or aging.

Inverted Nipple Symptoms

Changes in breast that can occur:

  • Breast tenderness, increased warmth or swelling
  • Breast irregularity or lump

Changes in nipples shape can include:

  • Retracted nipples where the nipple was raised above the surface but begins to pull inward and does not come out when stimulated
  • Inverted nipples, where the nipple is indented into the areola but will often come out with breast stimulation or during pregnancy

Nipple discharge can be:

  • Clear, discolored (brown or green) or bloody discharge
  • Milky (galactorrhea)
  • Present in one or both nipples
  • Present with pressure place on the breast or with no pressure which is called spontaneous discharge

Changes in skin around the nipple can include:

  • Tenderness, cracking or redness of the skin surface of the nipple
  • Puckers, rash or dimples on the skin of the nipple or the areola (darker skin surrounding the nipple)

Inverted Nipple Repair

Surgical methods can be used to correct inverted nipples and can be divided into 2 types:

  • Leave the milk ducts intact
  • Do not leave the milk ducts intact

In both cases, the objective is to reshape the nipple as well as the areola in order for the nipple to project out from the breast, improving the look of the breast while conserving the sensitivity of the nipples. The technique which leaves the milk ducts intact may as well help preserve the woman’s ability to breastfeed.

Inverted Nipple Cost

The average cost of the Inverter Nipple Repair in the United States is somewhere in between $2000 to $4000.


Through Medical Tourism, the same surgery can be obtained in Australia for in between $1500 to $2500. The surgery can be also done in the Philippines as well as India for much cheaper prices which can be found on the internet.

Inverted Nipple Treatment

The treatment of nipple discharge which is caused by conditions outside of the breast includes:

  • Changing medications which cause the discharge
  • Treatment for hypothyroidism, pituitary tumors as well as breast infections

Any abnormal findings on a breast ultrasound or mammogram will be biopsied and after that often removed.

The majority of women with discharge from the breast and who have a normal breast ultrasound, physical exam or normal mammogram may be followed over 1 to 2 years with a physical exam and mammogram follow up repeated during that time.

Removing some or all of the breast ducts can be done immediately or after a period of surveillance. In some case, a ductogram is done prior to any other surgery.

Antifungal creams, antibiotic creams as well as steroid creams can be used for treating any skin changes around the nipple.

For information on nipple care as well as breast care while breast-feeding, see:

  • Overcoming breastfeeding problems
  • Breastfeeding mothers – self-care
  • Breastfeeding tips

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