In this guide13 sections
- Key Points
- Can You Fix Inverted Nipples Without Surgery?
- Which Grade of Inverted Nipple Do You Have?
- How to Fix Inverted Nipples at Home: What the Evidence Shows
- Niplette Side Effects and Who Should Not Use One
- Inverted Nipples and Breastfeeding
- How to Fix Inverted Nipples at Home for Men
- Are Inverted Nipples Unhealthy? Soreness, Hygiene and Infection
- When a Newly Inverted Nipple Needs a GP
- When Is Surgery the Better Answer?
- Frequently Asked Questions
- References
- Talk to a Surgeon About Inverted Nipples
Key Points
- Inverted nipples are graded 1 to 3. Grade 1 nipples pull out easily and stay out, grade 2 pull out but sink back, and grade 3 cannot be pulled out at all.[1]
- Suction devices such as the Niplette are the most realistic way to fix an inverted nipple without surgery. They work best for grade 1 and some grade 2 nipples and need to be worn regularly for weeks to months.[2]
- The evidence for at-home methods is weak. Two randomised trials of Hoffman’s exercises and breast shells in pregnancy found no improvement in breastfeeding rates, and a systematic review found no non-invasive method with good long-term data.[3][4][7]
- Many women with inverted nipples can still breastfeed, especially with early help from a midwife or infant feeding specialist and, where needed, a breast pump or syringe to draw the nipple out before a feed.[5]
- A nipple that has newly turned inwards, particularly on one side only or with a lump, discharge or skin change, should be checked by your GP before you try any device.
- When the nipple is held in by tight fibrous bands (grade 3, or grade 2 that keeps relapsing), inverted nipple correction surgery under local anaesthetic is the more reliable long-term answer.
Most people searching for how to fix inverted nipples at home want to know two things: does anything actually work without surgery, and will it last? The honest answer is that some inverted nipples can be drawn out and kept out with a suction device such as the Niplette, but many cannot, and the published evidence for home methods is thinner than product descriptions suggest. This guide covers what works, for whom, how long it takes, and when surgery is the better use of your time.
If you want the background on causes and what an inverted nipple is, start with our guide to what inverted nipples are and why they happen. If your nipples sit level with the areola rather than pointing inwards, our article on flat nipples is the better fit, although most of the non-surgical methods below apply to both.
Can You Fix Inverted Nipples Without Surgery?
Sometimes, yes. An inverted nipple is pulled inwards by milk ducts that are shorter than usual and by bands of fibrous tissue underneath the nipple. Non-surgical methods all try to do the same thing: hold the nipple out for long enough, often enough, that those ducts and bands gradually stretch.
Whether that works depends almost entirely on how tight the tissue is. A 1999 grading study of 107 inverted nipples in Plastic and Reconstructive Surgery found minimal fibrosis in grade 1 nipples, moderate fibrosis in grade 2 and severe fibrosis in grade 3.[1] Gentle, sustained traction can stretch loose tissue. It is much less likely to overcome dense scar-like bands.
So the realistic picture is:
- Grade 1: good chance of improvement with suction or regular manual eversion, and many do not need treatment at all.
- Grade 2: worth a trial of a suction device, but relapse once you stop is common.
- Grade 3: home methods rarely keep the nipple out; surgery is usually needed if you want a lasting change.
Which Grade of Inverted Nipple Do You Have?
You can get a fair idea at home. With clean hands, place your thumb and forefinger on the edge of the areola, about 2–3 cm from the base of the nipple, and press gently inwards and together. This is sometimes called the pinch test.
Grade 1 inverted nipple
The nipple comes out easily with light pressure, cold or touch, and stays out for a while afterwards. Breastfeeding is usually unaffected. Many people with grade 1 nipples simply notice that the nipple is tucked in at rest and want it to look more even.
Grade 2 inverted nipple
The nipple can be pulled out, but it goes back in once you let go. This is the most common grade.[1] Grade 2 is where a suction corrector is most worth trying, as there is enough give in the tissue to stretch, but results vary and the nipple may sink back if you stop too soon.
Grade 3 inverted nipple
The nipple stays inverted and can hardly be pulled out at all, even with firm pressure. The ducts are short and tethered by dense fibrous tissue. Suction devices are unlikely to work here and can make the nipple sore without changing its position.
If you are not sure which grade you have, a surgeon can tell you in a few minutes at a consultation, including whether one side differs from the other, which is common.
How to Fix Inverted Nipples at Home: What the Evidence Shows
There are several methods people try. Here is what each involves and what is known about it.
Suction devices: the Niplette and other inverted nipple correctors
The Niplette is a small clear plastic cup, shaped like a thimble, with a valve and a syringe. You place the cup over the nipple, draw the plunger back to create gentle suction, then detach the syringe so the cup stays on by itself under your clothes. The suction holds the nipple out inside the cup, which keeps the ducts and fibrous bands behind it under mild, constant tension.
The device was described by a London plastic surgeon in a 1994 paper in the British Journal of Plastic Surgery ↗, which reported that patients found it comfortable and easy to use and that breastfeeding was possible after treatment.[2] It was a small, uncontrolled report, and the author’s prediction that the device would replace surgery has not been borne out.
Many similar products are now sold as an “inverted nipple corrector”, “nipple suction corrector”, “nipple everter” or “nipple puller”. Most work on the same principle: a cup and a small bulb or syringe to create suction. They differ in the size of the cup and the strength of suction, and quality varies.
How to use a Niplette or suction nipple corrector
Always follow the instructions supplied with the device you buy. In general:
- Clean the device and your skin. Wash the cup in warm soapy water and dry it before each use.
- Start gently. Draw back only enough suction to bring the nipple into the cup. You should feel a pull, not pain.
- Build up wear time slowly. Begin with short periods and increase over the first week or two. Many people wear the cup overnight or under a bra during the day.
- Be consistent. Results depend on regular use over weeks to months. Using it occasionally is unlikely to change anything.
- Check the skin every day. Some redness around the rim is common. Stop if the nipple becomes sore, blistered, cracked or discoloured, and let the skin settle before trying again with less suction.
Does the Niplette work permanently?
For some people, yes. Once the tissue has been stretched for long enough, a grade 1 or mild grade 2 nipple may stay out on its own. For others, the nipple gradually sinks back weeks or months after they stop, especially where there is more fibrous tissue. There are no good long-term studies that tell you what proportion of people keep the result. A 2016 systematic review in The Breast ↗ looked for treatment studies with at least 10 nipples and six months’ follow-up and did not find a single non-invasive method that met those basic criteria.[7]
In practice, a fair trial is two to three months of regular use. If the nipple is still going back in after that, more of the same is unlikely to help, and it is reasonable to consider surgery.
The Hoffman technique
The Hoffman technique (Hoffman’s exercises) is a manual stretching method. You place your thumbs on opposite sides of the nipple at the base, press in gently and pull the thumbs apart, stretching the areola away from the nipple. You repeat this horizontally and vertically, around the nipple, a few times once or twice a day.
It is free and harmless for most people, but the evidence for it is disappointing. A randomised trial of 96 pregnant women in the BMJ in 1992 found that sustained improvement in nipple shape was no more common with Hoffman’s exercises than without them.[3] A larger multicentre trial of 463 women in the UK and Canada found that 46% of women who did the exercises were breastfeeding at six weeks compared with 44% who did not, a difference that could easily be chance.[4]
A 2023 systematic review of nine studies was more positive, concluding that Hoffman’s exercises, the inverted syringe method and nipple exercises improved breastfeeding success in some studies, but the studies were small and varied.[5] A 2019 randomised trial in Aesthetic Surgery Journal gives a sense of scale: women who only did daily nipple exercises before pregnancy achieved successful breastfeeding in 52.5% of grade 1 nipples and 38.9% of grade 2 nipples, compared with around 80% after a minor procedure that fixed a traction device to the nipple for six months.[8]
The inverted syringe method and breast pumps
The inverted syringe method uses a 10 ml or 20 ml plastic syringe with the nozzle end cut off and the plunger put in from the cut end, giving a smooth rim to place over the nipple. Gently drawing the plunger back pulls the nipple out for 30 seconds or so. It is mostly used just before a breastfeed so the baby has something to latch on to. A breast pump on a low setting does the same job and is often more comfortable. Neither is designed for all-day wear, and the change is usually short-lived, but they are useful tools in the first days of breastfeeding.
Nipple shields and breast shells
These are often confused. A nipple shield is a thin silicone teat worn over the nipple during a breastfeed. It gives the baby something firm to latch on to and can help where a flat or inverted nipple makes latching difficult. It does not correct the nipple itself, and it should be used with guidance from a midwife, health visitor or infant feeding specialist, as poor fit can reduce milk transfer.
A breast shell is a dome worn inside the bra during pregnancy, with a hole that presses on the areola to push the nipple forwards. In the 1992 BMJ trial, women who were advised to use breast shells were less likely to be breastfeeding at six weeks (29% compared with 50%), partly because more of them gave up or chose to bottle feed.[3] On that evidence we would not recommend breast shells as a way to fix inverted nipples.
Nipple piercing and “nipple banding”
Some people find that a nipple piercing keeps the nipple out, as the bar holds it in an everted position. There are no good studies of piercing as a treatment. It carries a risk of infection, abscess and scarring, it can damage the milk ducts, and if the jewellery is removed the nipple may go straight back in. If you do choose a piercing, use a licensed, experienced piercer and be aware that a previous infection or scarring can make later surgery more complicated.
“Nipple banding” refers to placing a small rubber ring around the base of the nipple after drawing it out with a syringe. One study included in the 2023 review reported that all the mothers in it were breastfeeding without the band by one month,[5] but bands can restrict blood flow, and this should only be done with guidance from a health professional familiar with the method.
What does not work
Creams, oils, massage, supplements, chest exercises and “natural” remedies do not change the length of the milk ducts or the fibrous tissue that holds the nipple in. Cold and stimulation will make a grade 1 nipple come out briefly, but they do not change it permanently.
Niplette Side Effects and Who Should Not Use One
Suction correctors are low risk when used sensibly, but side effects do happen:
- Redness, soreness or a ring mark around the areola from the rim of the cup
- Small blisters, broken skin or cracks on the nipple from too much suction
- Skin irritation or infection if the device is not kept clean
- Swelling of the nipple that settles after the cup is removed
Do not use a suction device on a nipple that has recently turned inwards until a doctor has checked it, or on skin that is broken, infected or inflamed. If you are pregnant or breastfeeding, check the manufacturer’s instructions and speak to your midwife first, as many suction correctors are not intended for use in pregnancy or while you are feeding. If you have had previous breast surgery, ask your surgeon before using one.
Inverted Nipples and Breastfeeding
Having inverted nipples does not mean you cannot breastfeed. Babies latch on to the breast, not just the nipple, and many women with flat or inverted nipples feed without any problem. Nipples often improve on their own during pregnancy: in the 1992 BMJ trial, more than half of the women who used no treatment had a sustained improvement in nipple shape by the first feed.[3] Our guide to breast changes in pregnancy explains what is normal.
Where latching is difficult, the most useful steps are practical and early:
- Ask your midwife or health visitor to watch a feed in the first few days and help with positioning and attachment.
- Draw the nipple out just before a feed with your fingers, a syringe or a breast pump.
- Shape the breast with your hand (like a sandwich) so the baby can take a bigger mouthful.
- Use a nipple shield if a feeding specialist suggests it, and review it regularly.
The NHS has practical advice on common breastfeeding problems ↗. In the 2023 systematic review, mothers with inverted nipples who had structured, repeated postnatal visits were more likely to be exclusively breastfeeding at one, three and six months than those given routine care, which shows how much good support matters.[5]
If you are planning a family, it is usually better to try non-surgical methods first. Some surgical techniques divide the milk ducts, and while duct-preserving techniques exist, no surgeon can guarantee that you will breastfeed afterwards. If you have recently stopped breastfeeding and your nipples have changed, our article on breasts after breastfeeding covers this.
How to Fix Inverted Nipples at Home for Men
Men can have inverted nipples too, often from birth, and the same grading applies. Suction correctors and manual eversion work in the same way for men as for women, with the same limits: grade 1 nipples often respond, grade 3 rarely do.
In men, an inverted nipple is sometimes made more noticeable by enlarged breast tissue under the areola. If the area is puffy or there is a firm disc of tissue, see our guide to puffy nipples or gynaecomastia surgery, as correcting the nipple alone may not give the result you want. Men can develop breast cancer, so a nipple that has newly pulled in, especially on one side, needs a GP appointment just as it would for a woman.
Are Inverted Nipples Unhealthy? Soreness, Hygiene and Infection
An inverted nipple that you have had since puberty is a normal variation and is not harmful in itself. Some people do have physical problems with it, though, not just concerns about appearance. Surgical papers describe breastfeeding difficulty, repeated inflammation and loss of sensation as reasons people seek treatment.[6]
The commonest day-to-day issue is hygiene. Skin cells, sweat and natural secretions can collect in the fold where the nipple sits, which can cause a smell, a white or cheesy discharge, soreness or repeated irritation. Gentle daily washing with water, drawing the nipple out to clean the fold and drying it carefully usually helps. Repeated infections or inflammation behind the nipple should be assessed by your GP and, if they keep recurring, are a reasonable medical reason to consider correction.
When a Newly Inverted Nipple Needs a GP
Nipples that have always been inverted, or that have gradually changed on both sides over years, are rarely a concern. A nipple that has recently turned inwards is different, and you should see your GP before trying any device if you notice:
- A nipple that has newly pulled in, flattened or changed direction, especially on one side only
- A lump or thickening in the breast or armpit
- Discharge from the nipple, especially if it is bloodstained or comes from one side
- A rash, crusting or scaling on the nipple or areola
- Dimpling or puckering of the skin, or skin that looks like orange peel
These can be signs of breast cancer or other conditions that need investigation. The NHS lists nipple changes among the symptoms of breast cancer ↗, and NICE guidance on suspected cancer ↗ recommends urgent referral for people aged 50 and over with nipple retraction, discharge or other changes of concern in one nipple only. Many newly inverted nipples turn out to have a benign cause, such as duct ectasia or previous inflammation, but they need checking first. Do not use a suction device to “fix” a new inversion, as it can hide a change your doctor needs to see.
When Is Surgery the Better Answer?
Surgery is worth considering when:
- You have a grade 3 inverted nipple, or a grade 2 nipple that sinks back despite two to three months of regular suction
- You have repeated soreness, discharge or infection in the fold
- You are not planning to breastfeed, or you understand and accept the effect surgery may have on it
- You would rather have a single procedure than wear a device for months
Inverted nipple correction is a short operation, usually carried out under local anaesthetic, through a small incision at the base of the nipple. The surgeon releases the tight bands holding the nipple in and supports it from underneath so it stays out. For milder inversion, duct-preserving techniques are used where possible. A systematic review found recurrence of 0.6% after duct-preserving techniques and 9.9% after techniques that divide the ducts, although the studies were small and not directly comparable.[7] Your surgeon will explain which approach suits your grade and your plans for breastfeeding.
Inverted nipple correction before and after surgery at Centre for Surgery. Individual results vary.
Male inverted nipple correction before and after surgery at Centre for Surgery. Individual results vary.
Inverted nipple correction is often done on its own, but it can also be combined with other breast procedures; our guide to choosing a nipple or areola correction procedure compares the options, and nipple reduction is available for nipples that are long rather than inverted. Cosmetic correction is an elective procedure; if you believe yours has a medical reason, check with your insurer before assuming any cover. Prices are shown on the inverted nipple correction cost and procedure page, and finance is available, subject to status, through our finance options.
Frequently Asked Questions
Can pumping fix inverted nipples?
Pumping can draw an inverted nipple out for long enough to help a baby latch, and in some women regular pumping and feeding in the early weeks gradually loosens the tissue so the nipple stays out more often. It is not a reliable permanent fix, and it does little for grade 3 nipples.
Will inverted nipples ever go away on their own?
Occasionally. Some grade 1 nipples become more prominent during pregnancy and breastfeeding, and some teenagers find their nipples come out more as the breasts finish developing. Inverted nipples present since puberty in adults rarely correct themselves fully without treatment.
How long should you wear a Niplette each day?
Follow the instructions for your device. Most people build up from short periods to several hours a day, often overnight, and continue for two to three months. Consistency matters more than suction strength.
Can flat nipples be corrected without surgery?
Often, yes. Flat nipples usually have less tethering than inverted nipples, so suction correctors, manual stretching and drawing the nipple out before feeds tend to work better for them. If a flat nipple never projects despite this, a small surgical correction is possible.
Are inverted nipples less sensitive?
Some people find inverted nipples less sensitive, partly because the nipple is less exposed to touch. Sensation varies between individuals, and there is no evidence that suction devices reduce it. Any nipple surgery carries a small risk of changes in sensation, which your surgeon will discuss.
Is it normal for nipples to be inverted after pregnancy?
Nipples can look flatter or more inverted after pregnancy and breastfeeding, as the breast changes in volume and the skin stretches. If the change is gradual and on both sides, it is usually benign. A change on one side, or one that comes with a lump, discharge or skin change, should be checked by a GP.
How much does it cost to fix inverted nipples?
Non-surgical correctors are inexpensive to buy. Surgical correction costs more and depends on whether one or both nipples are treated and whether it is combined with another procedure. Our inverted nipple correction page lists current prices.
References
- Han S, Hong YG. The inverted nipple: its grading and surgical correction. Plast Reconstr Surg. 1999;104(2):389-395. doi:10.1097/00006534-199908000-00010 ↗
- McGeorge DD. The “Niplette”: an instrument for the non-surgical correction of inverted nipples. Br J Plast Surg. 1994;47(1):46-49. doi:10.1016/0007-1226(94)90117-1 ↗
- Alexander JM, Grant AM, Campbell MJ. Randomised controlled trial of breast shells and Hoffman’s exercises for inverted and non-protractile nipples. BMJ. 1992;304(6833):1030-1032. doi:10.1136/bmj.304.6833.1030 ↗
- The MAIN Trial Collaborative Group. Preparing for breast feeding: treatment of inverted and non-protractile nipples in pregnancy. Midwifery. 1994;10(4):200-214. doi:10.1016/0266-6138(94)90055-8 ↗
- Kaya Ö, Tecik S, Suzan ÖK, Kabul F, Koyuncu O, Çınar N. The effect of interventions on flat and inverted nipple on breastfeeding: a systematic review. J Pediatr Nurs. 2023;74:e1-e13. doi:10.1016/j.pedn.2023.07.024 ↗
- Sowa Y, Itsukage S, Morita D, Numajiri T. Inverted nipple correction with selective dissection of lactiferous ducts using an operative microscope and a traction technique. Aesthetic Plast Surg. 2017;41(5):1045-1048. doi:10.1007/s00266-017-0874-3 ↗
- Hernandez Yenty QM, Jurgens WJFM, van Zuijlen PPM, de Vet HCW, Verhaegen PDHM. Treatment of the benign inverted nipple: a systematic review and recommendations for future therapy. Breast. 2016;29:82-89. doi:10.1016/j.breast.2016.07.011 ↗
- Feng R, Li W, Yu B, Zhou Y. A modified inverted nipple correction technique that preserves breastfeeding. Aesthet Surg J. 2019;39(6):NP165-NP175. doi:10.1093/asj/sjy119 ↗
Talk to a Surgeon About Inverted Nipples
If you have tried a suction device without lasting success, or you would like to know your grade before deciding, you can book a consultation at our Baker Street clinic by calling 020 7993 4849 or using the form below. You will see the surgeon who would carry out your procedure, and further consultations before surgery are free.
