Patient's question:
I don't understand, it's very confusing what's going on? How can it be cured as soon as possible?Doctor's answer:
The breast should not only have a proper shape and size but also must include the nipple and areola. The nipple is the part where the infant suckles milk, and it is sacred to the mother. Moreover, only breasts with normal nipple and areola size, shape, and position are considered perfect. If a mature female's nipple is concave and retracted below the surface of the areola skin, not protruding above the areola plane, creating a condition where the area resembles an orifice, it is called nipple inversion. The degree of nipple inversion varies, with some cases only showing retraction of the nipple, while severe cases may involve the nipple being concave or even inverted. Nipple inversion not only affects the aesthetic appearance of the breast but also hinders breastfeeding function. The affected area is difficult to clean, and the recessed part can easily accumulate dirt and cause local infections. Since the breast ducts are connected to the, inflammation can spread to the breast tissue, leading to mastitis. Therefore, correction is necessary.Nipple inversion is primarily congenital but can also be caused by trauma, surgery, breast tumors, or fibrosis following mastitis. The main reason for congenital nipple inversion is the underdevelopment of smooth muscle in the nipple and areola, which inwardly pulls these muscle fibers. Additionally, the lack of supporting tissue beneath the nipple contributes to the inversion. Nipple inversion typically occurs bilaterally but can also affect one side. If the inverted nipple can be easily pushed or pulled back with slight pressure or traction, it is classified as mild nipple inversion, also known as correctable nipple inversion. This type of inversion can be corrected through non-surgical conservative treatments, with the best timing being before marriage or in the early stages of pregnancy. The specific methods include manual traction and mechanical traction.
Manual Traction: The individual manually pulls the nipple out of the skin using the thumb and index finger, either horizontally or vertically, and applies sustained or intermittent traction to the nipple for about 30 minutes per session, alternating between both nipples. This should be done 3-5 times daily.
Mechanical Traction: A manual or electric breast pump is used to apply negative pressure to draw the nipple out. The same principles apply—sustained or intermittent traction for 30 minutes per session, alternating between both nipples, 3-5 times daily.
Both of these correction methods can yield good results after about two months.
In cases of irreparable nipple inversion, also known as severe nipple inversion, surgical correction is the only viable option. The surgery involves completely releasing the tractioning muscle fibers and filling the area beneath the nipple with surrounding tissue to enhance support, lifting the nipple, and reshaping it. The procedure is typically performed under local anesthesia, with various techniques available depending on the specific condition. The surgery is conducted within the areola range, resulting in minimal scarring and, under normal circumstances, no damage to the sensory nerves of the nipple, so postoperative sensation is not impaired. The surgery generally does not damage breast ducts, so breastfeeding function is not affected.
It is worth noting that even after surgical correction, there is a possibility of recurrence. Therefore, after the stitches are removed (5-7 days post-surgery), manual traction should be applied to the nipple for 1-2 months. Those with access to mechanical traction may also use it to reinforce the effect and prevent recurrence.