The umbilicated nipple, also known as the invaginated nipple, is a frequent anomaly that can be a source of physical and psychological discomfort. The condition is often benign, but can make breastfeeding difficult or interfere with daily life. Umbilical nipple surgery offers an effective solution to the cosmetic nature of this condition. On the other hand, it can compromise any chance of future breastfeeding. The procedure is covered by the French Assurance Maladie. Here are the key points to bear in mind.
Umbilical nipple: definition of an invaginated nipple
An umbilicated, or invaginated, nipple is one that retracts into the breast rather than pointing naturally outwards. Considered a breast malformation, this anomaly is often present from birth, but can develop progressively over time. There are several stages of invagination, depending on the intensity of the retraction.
In the early stages, the nipple may be slightly retracted, but this remains discreet and causes little discomfort. At a more advanced stage, the nipple may be more deeply retracted, which can create tension and difficulties during certain daily gestures. In the most severe forms, the nipple is completely buried in the areola, making its appearance and shape particularly altered.
This phenomenon can affect one or both nipples, and its impact varies from one person to another, ranging from a simple aesthetic inconvenience to a more marked difficulty in everyday life.
Causes of umbilicated nipple
The main cause of umbilicated nipples is abnormal development of the milk ducts. It can also result from hormonal imbalance, particularly during puberty or pregnancy. Certain infections, traumas or physiological changes can also favour the appearance of this anomaly. In some cases, genetic factors are at the root of the condition.
Umbilical nipple surgery: which operation for an invaginated nipple?
Umbilical nipple surgery aims to straighten the nipple by freeing the milk ducts and reconstructing its shape. Performed under local or general anaesthetic, the operation involves making small incisions around the areola to allow the nipple to reposition itself correctly. We then perform a peripheral bursa suture to prevent the nipple from retracting again. The surgical procedure is relatively straightforward and can be performed on an outpatient basis, meaning that the patient can go home the same day. The aim of this surgery is essentially aesthetic. It restores the shape of the nipple, thus eliminating the complex associated with invagination.
Umbilical nipple surgery price: What is the price of an umbilical nipple operation?
The cost of umbilical nipple surgery can vary according to the complexity of the procedure, the technique, the care facility and the surgeon. A cure for an invaginated nipple costs around 1,500 euros. A detailed estimate is drawn up and given to the patient during the preliminary consultation to help her prepare for the procedure. The final price will include anesthesia and hospitalization costs.
Umbilical nipple surgery: possible reimbursement or coverage?
Surgery to correct an invaginated nipple is generally covered by French Social Security. A consultation with the surgeon is all that is required to validate the indication, normally without prior agreement. What's more, some mutual insurance companies may also reimburse all or part of the remaining costs associated with this cosmetic procedure, depending on the cover specified in the contract. It is therefore advisable to check with your insurer for more precise information.
Umbilical nipple surgery: what are the side effects?
As with any surgical procedure, umbilical nipple surgery carries certain risks. The most common complications are infection, hematoma and visible scarring around the areola. In rare cases, nipple sensation disorders may occur, as well as nipple necrosis. Unfortunately, nipple umbilication can recur in 5-20% of cases, depending on the surgical technique. In our series of minimally invasive surgery with bursa, recurrence was less than 2%. Careful post-operative monitoring can help prevent these complications. The surgeon will give precise instructions on how to care for the operated area and limit the risk of complications.
Umbilical nipple surgery: postoperative care
Post-operative care is usually straightforward. Patients may experience slight pain or discomfort in the days following the procedure. Analgesics may be prescribed to relieve pain. It is important to keep the operated area clean and to avoid excessive pressure on the chest for the first few weeks.
Scars are discreet and fade over time. It is advisable to limit strenuous physical activity during the convalescence period to promote proper healing. The results of the operation may be visible within the first few weeks, but complete healing generally takes between three and six months.
Umbilical nipple and breastfeeding: breastfeeding after surgery
After umbilical nipple surgery, breastfeeding is often affected, as the operation often involves cutting the galactophore ducts, essential for milk circulation. This operation often results in the loss of the ability to breastfeed, making breastfeeding impossible.
Patients wishing to breastfeed at a later date should discuss this with their surgeon before surgery to assess the merits of surgery and find alternatives, such as mechanical support with traction effect, where possible.
This procedure improves the aesthetic appearance of the nipple, but it's important to take into account the possibility of impaired breast-feeding capacity before deciding on the operation.
