Breast Procedures » Inverted Nipple Treatment with Nipple Piercing

Inverted nipple correction by female Seattle Plastic Surgeon

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Nipple piercing for inverted nipples.

I have found a simple and usually effective treatment for inverted nipples is nipple piercing!  Fortunately, Seattle is a pretty piercing friendly city and this treatment is well accepted by patients.

Inverted nipples are caused by short milk ducts that tether the nipple to the underlying breast. Procedures to release this tethering usually involve cutting the ducts and, in my experience, have a high rate of recurrence of the nipple inversion. Also, cutting the ducts likely interferes with subsequent lactation and could interfere with sensation. Piercing the nipple and holding it in place with a nipple barbell for about three months stretches out the ducts and thus far has resulted in low rates recurrence after the barbell has been removed. Piercing takes out maybe one or two of the ducts and does not damage the nerves and has not turned any of my patients into Marilyn Manson fans.

The procedure is done under a local anesthetic. For those with inquiring minds here are the details:  First I inject the nipple with Lidocaine which is a local anesthetic.  Yes, this involves a needle (a small one) and yes it stings some for a few seconds.  Then I clean the area with iodine and place sterile drapes around the nipples.  Next, I use a suture which is attached to a small curved needle to grab the inverted nipple and pull it out to length.  Once it is out to length, I use a needle and an IV to skewer the base of the nipple.  The barbell is placed through the IV catheter and then the IV catheter is removed and I secure the small end balls onto the barbell.  Now you know all my secrets but don’t try this at home.  There is some aching after the anesthetic has worn off and I have patients take Tylenol for this.  After care involves keeping the area clean with daily mild soap and water in the shower and keeping a Band-Aid or small dressing over the nipple until the holes are healed, usually a couple of weeks.  I ask patients to take it easy for a few days following the procedure and to make sure to come back in three months for removal of the barbells.  I ask patients to check the little balls on the end of the barbells every few days.  They could loosen and come off over time in which case the barbell would fall out.

I ask patients to leave the barbells in at least three months and then come back to have me take them out.  Most of my patients, however, do not come back because they like their piercings so much that they decline removal!

The cost of nipple piercing is $500 for unilateral piercing and $600 for bilateral piercing.  This includes the sterile instruments used for the procedure and the surgical steel barbells and follow-up care.

One more thing:  If you have a history of mastitis (if you don’t know what mastitis is you haven’t had it!), please let me know before your appointment.  I will phone in some antibiotics for you to take one day before and two days after the surgery.  The only significant infection I have had after this procedure is in a lady who had a history of mastitis.

To schedule a consultation with me, please call 206 467-1101.

I get lots of questions about this procedure.  Here are a few FAQs.  Please read through these before emailing me a question.  Most questions I receive are answered here.  

Q:  Why can’t I have this done at a tattoo or piercing parlor?

A:  Maybe you can.  As of November of 2017, I have been made aware by some very cranky piercers who discovered this webpage that some professional piercers are comfortable and adept at piercing inverted nipples.  They tell me that they can manipulate the nipple either by pinching its base or pulling it out with some forceps.  They do not use a local anesthetic but some use a topical anesthetic cream. I know that both tattoo and piercing cultures sometimes consider pain and suffering a part of the whole procedure experience.  I don’t share that ideology.  I try to keep things as comfortable as possible by using an injection of Lidocaine (the same stuff your dentist uses) which does sting when injected but just for a few seconds.   So there you have it.  You may find someone in a piercing parlor who does a great job at a considerably lower price than you pay for me to do it.  Go ahead and look around and if you find someone awesome, please let me know!  If you would prefer to come a board certified plastic surgeon, I would love to take care of your inverted nipples!  Just don’t tell the folks who pierced your navel!

Q:  Is there anyone in Cincinnati, Miami, Ritzville, Bozeman, Lexington, etc. do this procedure?

A:  I don’t know.  If you find someone who does, please let me know.  Please see the comment above about professional piercers.  I cannot endorse anyone doing this procedure, either M.D.s or professional piercers as I am not familiar with any else’s work in this regard other than my own.  I do endorse myself.

Q:  Why don’t all plastic surgeons do this?

A:  I don’t know.  I have presented this technique to groups of surgeons and nobody seems very interested.  It’s one of those little, fussy procedures that not everyone likes to do.

Q:  Do patients travel to Seattle just to have you pierce their inverted nipples?

A: Yes, they do.

Q:  Does it ever not work?

A:  Yes.  I’ve had a handful of patients have significant irritation that required removal of the piercings.  I’ve had one patient get an infection after she switched out her nice, boring surgical steel barbells for some flashy, cheap ones.  She needed removal and antibiotics. Please don’t do this!  If you want to switch out your jewelry after three months, make sure it is good, quality jewelry and not some cheap nickel trinket.  I have had two patients who had erosion of the barbell up through the top of their nipple.  I do not know why this happened in these two patients.  They both required removal of the barbells and I am not brave enough to try again.

Q:  If it doesn’t work and I have to remove my barbells, can we try again?

A:  Maybe.  It depends on how severe your problem was and if I think another try is worthwhile.  And I charge for another procedure.  If you bring your barbells back, I can reuse them and that will save you $60.

Q:  May I bring my own barbells?  I got some really cool ones at a tattoo parlor.

A:  Nope.  The barbells I use are implant grade surgical steel and a certain diameter.  Also the length of the barbell is determined by your nipple diameter.  So let me choose the right barbell that will work for your anatomy and my instrumentation.  You can switch to something else after three months if your promise to only use high quality jewelry.

Q:  What is the success rate?

A:  I don’t know.  How is that for honesty?   Many of my patients disappear and never follow up with me.  Also, most of my patients who do come back for follow-up don’t come back at three months for removal because they dig their piercings.  This includes my “older” patients.  I don’t think pierced nipples on a 60 year old are any more disturbing than a pierced naval on a 60 year old.  Can you tell I’m from Spokane?

Q:  Do you do the invasive surgical operations for inverted nipples?

A;  No, I do not.  After doing various nipple inversion corrections operations several times and having a high recurrence rate of the inversion, I just abandoned them.  There may be a fabulous procedure for correcting inverted nipples out there but I have not yet found it.  There are at least 20 different techniques and whenever there are that many ways to fix something, you can be sure that none of them works very well!

Q:  Will this make my nipples longer?

A:  Nope.  Your nipple length is set by God.  I just pull that nipple out where it belongs.  I can make long nipples shorter but that’s another topic.

Q:  Do you pierce non-inverted nipples?

A:  Nope.  You should go to a reputable piercing provider for that.  Look, I’m a surgeon.  I like to fix problems.  Inverted nipples are a problem.  Regular nipples that want a barbell are not a problem.  I will pierce a normal nipple for a lady who has a unilateral inversion and wants both nipples pierced.

Q:  What type of hardware do you use?

A;  I use implant grade surgical steel barbells.  The diameter is usually 14 gauge and the length depends on the diameter of the nipple.  It is necessary to use a barbell that has some extra length because there is always some swelling.  I encourage patients to switch out to just right barbells after about three months.  Make sure the barbells are either gold or surgical steel.  Cheep barbells can cause terrible irritation and inflammation.

Q.  Will I be able to breast feed a baby after this procedure.

A.  I don’t know.  I have not to date had any of my former piercing patients inform me about a lactation problem.  Piercing likely damages one or two ducts but leaves the other dozen or so intact.  Invasive procedures that cut all the ducts in order to pull the nipple out would be expected to make lactation very difficult or impossible.  Here is an article I found about this topic. Check it out.

Q:  Do you pierce any other, er, private areas.

A:  Nope.  And I don’t recommend it!

Q:  Can the piercing be done at the same time as a consultation?

A:  Yes, I can usually make that work.

To schedule a consultation with me, please call 206 467-1101.

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