Procedures not routinely provided by NHSScotland

Surgery to reverse nipple inversion.
New nipple inversion can be a sign of serious underlying disease and must be investigated and referred to the local breast surgery team.

Clinical Psychology

Referral to a specialist Clinical Psychologist may be made at the discretion of the vetting team.

BMI

Not applicable.

Considerations for treatment

New nipple inversion can be a sign of serious underlying disease and must be investigated and referred to the local breast surgery team.
Longstanding nipple inversion is common and a variant of normal and does not usually impair ability to breast feed.
Conservative measures using suction devices may be tried.
Psychology referral to aid understanding that the appearance is normal and to explore wider concerns may be of more benefit than surgery.
Surgery is not offered because it results in a numb nipple, renders subsequent breast feeding impossible and inversion often recurs over time.

Waiting Times

These patients are not subject to the 18 Weeks Referral to Treatment Standard.

Referrals for suspicion of malignancy should be made via the appropriate cancer pathway.

Treatment for these conditions is not routinely offered by NHSScotland and can only be provided on an exceptional case basis in line with the guidelines contained in this protocol.