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The 3 Grades of Inverted Nipples

3 grades of inverted nipples
Medically reviewed by Dr. Omar Tillo MD, MS, EBOPRAS, FRCS (Plast)

Inverted nipples are a common condition where the nipples point inwards or lie flat rather than pointing outwards. Also known as retracted nipples, the condition can occur in one breast or both, and affects an estimated 10% of the population. 

While inversion is a normal variation in nipple shape and usually nothing to worry about, many people – especially women – consider inverted nipple surgery due to concerns about breastfeeding or for aesthetic reasons. 

This guide will take a closer look at the three grades of inverted nipples, including all the information you need to know about what causes the condition and how to correct it. 

Our body contouring surgeon, Dr Omar Tillo, is highly skilled and experienced when it comes to inverted nipple surgery and will be able to design a bespoke treatment plan for you. 

What Causes Inverted Nipples?

There is a range of factors that can cause inverted nipples. Explained below are some of the most common:

  • Aging – milk ducts tend to shorten as you approach menopause which can sometimes cause your nipple to move into your body. 
  • Breastfeeding – your nipples might turn inwards if you’ve recently finished breastfeeding. This is due to a shortening or scarring of the milk ducts. 
  • Mastitis (bacterial infection) – this condition can occur if bacteria gets into your milk ducts and causes an infection. Mastitis is particularly common in women who have recently given birth, are breastfeeding, or have cracked or pierced nipples. 
  • Congenital inversion – some people are born with inverted nipples due to the nipple base or milk ducts not properly developing in the womb. 
  • Breast cancer – it could be a sign of breast cancer if one or both of your nipples suddenly become inverted. Other signs to look out for include a lump or thickness in your breast, as well as dimples or skin changes on the surface of your breast. 
  • Abscess under the areola – infection can also occur in the glands underneath the areola and form an abscess. While this is rare and is typically associated with smoking, diabetes, or nipple piercing, it can significantly retract the nipple. 

How Do I Know What Grade My Inverted Nipples Are?

As mentioned, doctors grade inverted nipples according to three distinct levels. These are dependent on the degree of inversion, as well as the mobility of the nipple. 

Grade 1 Inverted Nipples

This is the mildest form of the condition and is classified by either flat or slightly inverted nipples. Typically, women with this grade of inversion encounter no major problems with breastfeeding. The nipple can easily be pulled outward and may maintain its projection with cold or stimulation. 

Grade one inverted nipple
Grade 1 Inverted Nipple

Grade 2 Inverted Nipples

Grade 2 inverted nipples have a more inverted appearance than grade 1. The nipple can still be pulled outwards. However it quickly retracts back to its original shape. Women with this grade of inversion may find it difficult to breastfeed. 

Grade 2 inverted nipple
Grade 2 Inverted Nipple

Grade 3 Inverted Nipples

This is the most serious form of the condition and is classified by a severely inverted nipple appearance. It is very difficult to manually pull the nipple out – with the nipple immediately retracting if done so. Breastfeeding with this degree of inversion may be very difficult or impossible.

Grade 3 Inverted Nipple
Grade 3 Inverted Nipple

How To Correct Inverted Nipples

First, discuss with your doctor any concerns you have before committing to treatment. This is because the severity of the inversion often determines the most effective treatment method. 

  • Surgery – the majority of inverted nipples are treated through surgery. A surgeon will first assess your inversion, who will then choose a suitable surgical technique to change the shape of the nipple so that it points outwards. 
  • Hoffman’s technique – this manual exercise can be performed at home and is useful if your nipples are flat or mildly inverted. Simply place your thumbs on either side of the base of your nipple and press firmly into the breast tissue, pulling your thumbs slowly apart. Work your way around all sides of the nipple until it projects outwards. 
  • Suction devices – your doctor or healthcare professional may suggest pulling the nipple outwards with a suction cup device. This type of treatment is most effective for grade 1 nipples but may take up to three months to see a noticeable change. 

Schedule a Consultation With CREO Clinic Today

If you are interested in correcting your inverted nipples through surgery, contact the CREO Clinic to schedule a 1-on-1 consultation with Dr Tillo. 

With years of experience in the field, he will be able to design a bespoke treatment plan according to your individual needs and desired aesthetic.

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