The appearance of a woman’s nipples
is more than an aesthetic matter. Although a lot of emphasis is placed on appearance
of the nipple and areola, there can also be functional problems. Women who have
inverted nipples often have trouble with breast-feeding, since the child can
not suck on the nipple itself. There are special breast protectors that can
be used to help with this problem, but many women are nevertheless unable to
nurse their babies. Other problems associated with inverted nipples are eczema
and accumulation of secretion and dirt in the depression.
The nipple and the
areola – anatomy
The nipple
has about fifteen to twenty-five small ducts which lead to the mammary gland.
Between these ducts are strings of connective tissue which are attached
to the deeper-lying glandular tissue. If these strings are too short, the
nipple is pulled in. The strings may sometimes be stretched by nursing,
and the nipple often protrudes more afterwards. In the areola are small
glands that produce a tallow-like secretion that keeps the area lubricated.
These make the areola look lumpier than the surrounding skin.
Inverted nipples
No special tests
or preparations are necessary beforehand, other than those described in the
first section of the book. The operation is a relatively small one, and can
be performed with local anesthetic alone. There are several ways it can be
done. In most of them an incision is made in the skin and the strings of connective
tissue are cut so that the nipple can protrude more. In many of these methods,
however, the ducts to the mammary gland are also severed, which makes future
nursing impossible. The strings of connective tissue may also be removed with
microsurgical technique, leaving the ducts in place. The incision can be made
either through the nipple or at the edge of it. The complications and risks
are described in the next section.
A method of pulling
out inverted nipples without resorting to surgery is available. A small, specially
constructed vacuum cup is placed over the nipple and the air is pumped out
of it. The apparatus is marketed under the name Niplette. Vaseline is usually
applied around the area to make an airtight seal so the vacuum can be maintained,
and surgical tape is placed on all this to hold it in place. The nipple must
be pulled out by the vacuum for a long time. The Niplette is usually left
in place during the day, and removed only to inspect the area for sores or
signs of irritation. After a period of treatment that usually lasts for several
weeks, the short tissue strings are gradually stretched and the nipple will
begin to protrude more. The method does not work on all patients with inverted
nipples. For many of these, a combination of surgery and post-operative treatment
with Niplette is often recommended.
