01Article · Nipple inversion correction
Inverted nipples —
when correction is appropriate, and when it isn't.
Inverted nipples are common — present in under 9% of the population — and most people who have them have lived with them for years. Whether surgical correction is the right next step depends not on the anatomy alone, but on what the inversion is doing to daily life, what other options have been considered, and whether the timing is right.
02Why this article exists
More common
than people think.
An epidemiological study cited in the cosmetic surgical literature found that under 9% of the population have inverted nipples. That is roughly one in eleven people — far more common than the conversation around it would suggest. Most patients who come to see us about it have lived with it quietly for years, sometimes since adolescence, and the decision to enquire is rarely impulsive.
The first thing worth saying clearly: inverted nipples are not, on their own, a medical problem. They are an anatomical variant. Many people have them, live with them, and never think about surgery. Some develop physical symptoms — irritation, hygiene difficulty, mild discomfort — and only then consider correction. A smaller group come because the inversion has affected how they feel in clothing or intimacy, and that has been the same answer at the second consultation, weeks after the first.
More on the potential risks of cosmetic surgery is available on our risks page.
— Dr Kishen Nara, RevAesthetic.
03First — investigate, not operate
New-onset inversion
is different from lifelong inversion.
The most important distinction we draw at the first consultation is whether the inversion has been present since adolescence, or whether it is new. Lifelong inversion is generally benign and is the typical reason patients consider cosmetic correction. New-onset inversion in an adult — a nipple that has changed from previously everted to inverted, particularly on one side only — is something we ask to be investigated by a general practitioner or breast specialist before any cosmetic decision is considered. There are causes of new inversion that need to be excluded first, and that step is not optional.
If you have noticed a change in one or both nipples, or any associated skin change, lump, or discharge, please discuss it with your GP before booking a cosmetic consultation. We will ask about it anyway at our first meeting, and the answer informs everything that comes after.
04The decision framework
When correction
is appropriate — and when it isn't.
The lists below are the same conversation we have at consultation, written out. They are not a checklist that decides for you. They are the framing Dr Nara uses to help patients work out whether now is the right time, whether surgery is the right answer, and whether doing nothing is also a valid option.
When surgery may be appropriate
- The inversion has been present long enough to know it isn't going to resolve on its own — generally beyond puberty or beyond breastfeeding.
- It is causing physical symptoms — recurrent irritation, difficulty with hygiene, intermittent discomfort.
- It is affecting how the patient feels in clothing, intimacy, or daily life — and that has been the same answer at the second consultation, weeks after the first.
- Breastfeeding is no longer planned, or the patient has been counselled about the possibility that surgery may affect future breastfeeding depending on technique.
- Other causes — recent skin changes, new lumps, recent inversion in a previously everted nipple — have been excluded by a general practitioner or breast specialist.
When surgery may not be the right step
- The change is new and has not been investigated. Any new-onset nipple inversion in an adult should be reviewed by a GP first.
- The patient is planning to breastfeed in the near future and is not ready to accept that some techniques may interrupt ductal continuity.
- There is body-image distress that has not been talked through with the patient's GP or psychologist — surgery is rarely the right first response to that.
- The patient is being pushed by someone else into the decision — a partner, a family member, social pressure.
- The inversion is mild and has not actually changed how the patient lives day-to-day.
05What the evidence shows
Correction at the same time
as breast augmentation.
A question that comes up regularly is whether inversion correction can be done at the same operation as breast augmentation with implants — or whether the two procedures should be staged. The question matters because little had been written on it in the surgical literature dating back to the 19th century.
Dr Nara, together with Dr Darryl Hodgkinson, published research analysing this. The study examined whether the revision rates of simultaneous nipple inversion correction with breast augmentation were comparable to those of isolated nipple inversion correction. The finding: revision rates were comparable, when specific techniques were used. Not every technique has been demonstrated to work safely in combination with augmentation, which is why the technique selection — and whether to combine the procedures at all — is part of the consultation conversation rather than a default approach.
The paper is referenced internationally and is summarised on our nipple inversion correction page, including the demographics of the patients studied. The exact technique appropriate for an individual depends on the inversion grade, the surrounding breast tissue, and what the patient has decided about future breastfeeding.
Citation: Nara, Kishen; Hodgkinson, Darryl J. "Correcting Nipple Inversion Simultaneously with Implant Augmentation of the Breast, Using the 'Pirelli' Technique."
06Anatomy
What the procedure
actually addresses.
Nipple inversion is generally caused by short or tethered ducts and supporting fibres pulling the nipple inward. Correction works by releasing or reorganising those structures so the nipple sits in a projected position. Techniques vary in whether — and how much — they affect ductal continuity, which is why the patient's view on future breastfeeding matters at the consultation.
07What to expect
From first consultation
to follow-up.
The first consultation is face-to-face with Dr Nara. We discuss the inversion in detail — when it began, whether it is one-sided or both, whether it has been investigated, whether breastfeeding is planned, and what change you would like to see. We also discuss the option of doing nothing, which remains a valid choice throughout the process.
A second consultation follows after a reflection period. This is a requirement under Medical Board of Australia guidelines for cosmetic surgery, and we treat it as a feature of safe practice rather than a formality. Patients who decide not to proceed at the second consultation are not asked to justify the decision — sometimes the right answer is no, or not yet.
The procedure itself is performed in an accredited day-hospital setting. Recovery generally takes a week to ten days for the immediate phase, with the soft tissues continuing to settle over the following weeks. The exact recovery profile varies from patient to patient depending on anatomy, the technique used, and whether the procedure is performed in isolation or combined with breast augmentation. Specific instructions are provided at the consultation and reviewed before surgery.
08About the practitioner
Dr Kishen
Nara.
Dr Kishen Nara is a registered medical practitioner. He sees patients across Melbourne, Tasmania and Adelaide. The team at RevAesthetic includes practice manager Cate, Patient Liaison Jenny, and registered nurses, all involved in supporting your enquiry.
All assessments are conducted in line with Medical Board of Australia guidelines. A second medical opinion is encouraged at any stage. New-onset nipple changes should be investigated by your general practitioner before any cosmetic consultation.
- MBBSBachelor of Medicine, Bachelor of Surgery — Monash University
- FACCSM(Surg)Surgical Fellow, Australasian College of Cosmetic Surgery and Medicine
- AHPRARegistered medical practitioner — General Registration MED0001201549
- Pub.Co-author, 'Correcting Nipple Inversion Simultaneously with Implant Augmentation of the Breast, Using the Pirelli Technique' (2020)
09Enquire
Begin a
conversation.
Consultations are conducted personally by Dr Nara across Melbourne, Tasmania and Adelaide. We respond within one business day. There is a written reflection period before any decision, and a second medical opinion is encouraged at any stage.
10Continue reading
More from
the journal.
- 2026 Breast augmentation in Melbourne — choosing implant size honestly
How implant size is actually decided at consultation — tissue check, frame width, soft tissue thickness, and lifestyle — written for patients researching breast augmentation. - 2024 Three Recommendations for Breast Implant Surgery
Three practical recommendations from Dr Kishen Nara on breast augmentation in Melbourne. - 2022 Just Breast Implants?
An editorial guide for anyone new to breast implants — what to ask, why training matters, honest cautions about size, and how to choose a doctor who has taken time to understand you.
Disclaimer: All cosmetic procedures have inherent potential risks and complications. We encourage you to seek a second opinion from a qualified medical professional before any procedure. New-onset nipple inversion in an adult should be investigated by your general practitioner before a cosmetic consultation is considered. Material on this page is educational in nature and is not generalisable — outcomes vary significantly between patients depending on genetic composition, medical history and individual circumstances.