Umbilical nipples

The cause of invaginated or inverted nipples is an inversion of the nipple tip due to the shortness of the milk ducts through which breast secretions flow during breastfeeding.

The shortened ducts draw the nipple inwards.

There are two main reasons for this shortening:

• congenital causes, most often related to a malformation;
• acquired causes, linked to a fibrous scarring process on top of significant inflammation. This may be the case following trauma, a bite, a piercing or, more rarely, surgery.

When the nipples are only slightly retracted, the patient can move them back into position (Hoffman manipulation).

In other cases, the intussusception persists: it can prevent all breastfeeding and greatly alter intimate life.

The nipple debriding proposed by Dr Santini is a simple, minimally invasive breast procedure offering an excellent aesthetic result.

Before any nipple debridement, a plastic surgery consultation with Dr. Santini is mandatory. She will check for any contraindications and take medical photographs.

Preoperative mammography is systematically performed.

Dr Santini will explain other pre-operative precautions and expectations: functional recovery on breastfeeding is possible, but never guaranteed.

Social security provides partial coverage for inverted nipples, supplemented to a greater or lesser extent by your health insurance.

Hospitalization for umbilicated nipples is performed on an outpatient basis, with the patient going home the same day.

Anesthesia is usually local, sometimes supplemented by neuroleptanalgesia. In the case of simple local anesthesia, there is no need to fast.

A short general anaesthetic is possible, however, if the patient so desires.

Debridement of retracted nipples can be performed in 30 to 45 minutes.

After disinfecting the skin, Dr Santini cuts the milk ducts beneath the nipple. The nipple is then freed and can protrude.

To prevent recurrence through scar reconnection between the milk ducts, 2 small flaps taken from the areola are positioned between the nipple and the mammary gland. The tissue is remodeled and the ducts cannot retract.

Finally, to keep the nipple erect, its base is tightened with a frame stitch.

The nipple is thus returned to position, and the breast regains its sensuality.

A work stoppage of 1 to 3 days is preferable.

It's a sick leave if the nipple operation is reimbursed by social security.

The result of correcting an umbilicated nipple is immediate. In the days that follow, the nipple is slightly de-epithelialized, forming a crust. With the application of a little Vaseline, healing is rapid.

The small dressing is removed 24 hours after the procedure. Absorbable sutures fall out spontaneously 10 to 15 days after the procedure. The first shower is permitted the following day. Pain is minimal and well relieved by simple analgesic treatments.

After nipple debridement, there may be a reduction in sensitivity: this is usually transient, sometimes lasting a few weeks. Breast monitoring by mammography as part of systematic breast cancer screening is not affected by this procedure.

It is advisable to wait at least 1 year before having a pregnancy, to give the nipple time to recover its ability to breastfeed: however, this functional recovery of lactation is never a certainty.

• A day at the clinic and a local anaesthetic
• No professional downtime
• Immediate aesthetic results

What to do before umbilical nipple surgery?

• 1 preliminary consultation with your plastic surgeon, including the taking of medical photographs
• Delivery and signature of the estimate, respecting the 15-day legal delay between the first consultation and the umbilicated nipple debridement surgery.
• Anesthesia consultation, blood test, mammogram as required.

How is umbilical nipple surgery performed?

• Local anesthesia with or without sedation, general anesthesia may be used.
• 30 to 45 minutes depending on the technique used
• No hospitalization: same-day discharge without heavy care

What is the post-operative course of umbilical nipple surgery?

• Follow-up visit with Dr Christelle Santini 7 to 10 days after surgery.
• Sutures used in umbilical nipple surgery are absorbable.
• Sport cessation after umbilical nipple debridement for 15 days.
• Return to work possible the next day
• Final result after 1 month of invaginated nipple surgery