A flat or inverted nipple has been reported to occur in 10-20 % of the female population and rarely in males. This is a congenital problem that results from fibrosis and shortening of the milk ducts. It can occur in disease states such as breast cancer but this is much less common.
Nipple inversion can be constant but on many occasions nipples may evert during pregnancy, breastfeeding, cold or sexual arousal. Many women opt for surgical correction if the nipple fails to protrude at all.
Surgical correction of the inverted nipple can be performed under local anesthesia on an outpatient basis. The basic principles of the procedure involve the severing of the ducts that prevent the nipple from protruding. There are many surgical approaches to correction depending on the severity of the condition.
Prior to considering surgery a woman should be aware that if the milk ducts are severed she will not be able to breastfeed. Also there is a remote possibility that there may be some loss of sensation in the nipple.
Another condition that I commonly treat is enlarged, protruding nipples, also referred to as nipple hypertrophy. This is embarrassing for both women and men. Women are concerned when the nipple is noticeable through their outer garments. Men are more concerned when they take off their shirt in the gym or pool side. A nipple reduction is a relatively easy problem to solve surgically in my office in Buffalo or Williamsville, New York.