An inverted nipple does not protrude above the surface of the areola or falls into the breast instead of forming a protrusion. The areola is the round area of pigmented skin that surrounds the nipple.
Inverted nipples are also called sunken, flat, recessed or inverted nipples. Some people are born with this anatomical feature, while others develop it later in life.
Inverted nipples can occur in both men and women. Some people have only one nipple that is indented.
Inverted nipples do not usually indicate a health problem. In addition, they do not always complicate breastfeeding, since during this process the baby can completely capture the areola.
However, with a strong inversion, women may encounter serious difficulties when feeding, and sometimes the child’s consumption of milk from the mother’s breast becomes completely impossible.
In this current article, we will look at the reasons for the development of inverted nipples, and also explain how they can affect feeding and breast sensitivity. We will also discuss the available treatments for this condition.
How normal is it to have inverted nipples?
Between 2 and 10% of women have at least one inverted nipple
Inverted nipples are not an anatomical abnormality and are usually neither a cause nor a consequence of serious medical conditions. In general, doctors do not think that people need any treatment in such cases.
However, therapy may be needed if the cause of sunken nipples is a serious health problem, such as inflammation or cancer in the breast.
According to American experts, from 2 to 10% of women have at least one inverted nipple. Men can also develop this feature.
Some people find that inverted nipples make breastfeeding difficult. In this case, stimulation may cause partial straightening of a flat or recessed nipple, and if the nipple is severely indented, the baby may need to capture the full areola during feeding. Some women find that their nipples become less recessed into their breasts after breastfeeding.
Treatment options
The presence of a third nipple in a person is not considered a disease. Therefore, no treatment is required. The deviation in question is not considered a deformity, but the patient has a desire to get rid of the tumor. In this case, surgical treatment is performed.
Before an operation is carried out, it must be well planned. For this, specialized equipment is used. The therapy is carried out under the supervision of a plastic surgeon.
In routine operations to remove an additional nipple, it is not necessary to hospitalize the patient. The doctor is obliged to prescribe a set of examinations. If any diseases are detected, they must be cured before surgery. The removal procedure is carried out under local anesthesia. The duration of the operation is 15-45 minutes. The sutures dissolve within a week. Then the bandage is removed.
After the operation, the doctor gives recommendations on how to restore the body. The patient should avoid strenuous physical activity for a month. During the postoperative period, it is useful to eat foods rich in vitamins. Since intervention in the body is a great stress for it, nutrition should be moderate. The main condition of the diet is to refrain from smoked, fried and spicy foods. It is better to eat whole grain cereals and drink dairy products.
How are inverted nipples treated?
Sometimes people express a desire to change the shape of their nipples due to difficulties that may arise with breastfeeding or for aesthetic reasons.
To solve the problem, modern medicine offers the following methods.
Hoffman technique
This technique has been successfully used since the fifties of the last century. It includes nipple stretching exercises that can be performed at home:
- place two thumbs on either side of the base of the nipple, but not outside the areola;
- press your fingers into the breast tissue, and then, holding the pressure, move your fingers away from each other;
- change the position of your fingers and repeat the procedure.
Such manipulations should gradually lead to the nipple coming out. However, the time required to obtain a satisfactory result varies from person to person.
People can perform Hoffman exercises during periods when they want to achieve elevation of the nipples above the areolas. It is difficult to predict how long this effect will last, so it is better to perform the described manipulations at least once a day. With regular exercise, your nipples will come out more often.
However, it should be pointed out that the effectiveness of the Hoffman technique has not been scientifically proven. In addition, each person's breasts have their own characteristics, so for some people nipple stretching exercises do not help at all.
Suction devices
The modern market offers suction devices that are designed specifically for correcting inverted nipples. People wear most of these accessories under their clothes for a long time.
Such products are sold under various names, for example:
- nipple formers;
- nipple correctors;
- nipple pullers;
- nipple extractors.
The operating principle of suction devices is based on pulling the nipple into a small cup. This process stimulates the nipple and causes it to emerge from the breast tissue. When used over a long period of time, suction devices help loosen the nipple tissue, allowing the nipple to remain extended for a longer period of time.
The effectiveness of suction devices has not been scientifically proven, so they may also not lead to the expected result. However, most suction devices are inexpensive, so this method is definitely worth trying.
Piercing
Nipple piercings sometimes also cause nipples to emerge from the breast. This happens because the jewelry that is inserted into the piercing site can support the nipple in an upright position.
Breast pump and syringe
A good nipple puller is a breast pump. In addition, it helps women avoid stagnation of milk in the glands.
There are both electric and manual devices. In the case of a mechanical apparatus, pulling is carried out using a special pear. The operating principle of both devices is the same. A special flange is applied to the nipple, which should completely cover the areola. Afterwards, the woman should turn on the breast pump (electric) and let the device do its job. You should choose a power that does not create a feeling of discomfort.
When using a breast pump not only for the purpose of expressing, but also as a device for pulling out the nipples, it should be taken into account that it stimulates milk production.
All actions aimed at stretching the nipples are recommended to be carried out after childbirth
The milk collected using this method can be immediately given to the baby from a bottle.
The device can be replaced with a regular medical syringe. To use it, you need to cut off the edge on the side where the needle is to be inserted. To prevent uneven cut edges from damaging the skin, it is recommended to pull out the piston and insert it from the reverse side. You should use syringes whose barrel diameter corresponds to the size of the nipple.
After applying a homemade traction device to your chest, you need to carefully begin to pull its piston until slight discomfort appears. When removing the syringe, the pressure created by it needs to be slightly relieved by moving the piston in the opposite direction, and the nipple will come out easily.
The homemade device must be kept clean at all times. It is washed with hot water not only before use, but also after use.
Why do inverted nipples occur?
You should see a doctor if one or both nipples suddenly recede into your breast
Some people are born with recessed nipples. In medical practice, this condition is usually described by the term “congenital inversion.” However, sometimes the nipples retract into the breasts later in life, and in such cases, doctors call the inversion acquired.
Acquired inversion may indicate the development of underlying medical problems, such as inflammation of the breast tissue. People should see a doctor if one or both nipples suddenly recede into the breast.
Medical conditions that can cause nipple inversion include the following:
- mastitis, that is, an infection of the mammary glands;
- mammary duct ectasia, which is an abnormal dilation of the milk ducts in the breast;
- abscess under the areola;
- complications after breast surgery;
- chest injuries;
- gynecomastia;
- tuberculosis;
- holoprosencephaly, chronic infections and monocytosis;
- mammary cancer.
Breast cancer usually causes other changes in the breast. If symptoms such as swelling, peeling of the nipples, or nipple discharge occur, women should be examined by a doctor.
Symptoms and diagnosis of inverted nipple
An inverted or flat nipple does not protrude outward - it is completely located in the mammary gland, either level with the areola, or even below it. To determine the deformation of the nipple, you can perform a test: lightly squeeze the nipple at its base (pinch it between the index and thumb). If the nipple moves outward, there is no deformation (such a nipple is called hiding), but if the nipple is retracted, that is, it goes even deeper (in this case they say that the nipple is inverted), therefore, there is every reason to suspect a pathology and consult a specialist. Women with inverted nipples often complain of pain in the mammary glands, which intensifies during lactation .
Diagnosis of pathologies associated with an inverted nipple is made by a mammologist. After a visual examination, he decides whether the patient needs to undergo ultrasound of the mammary glands, mammography and, if the development of a tumor process is suspected, cytological examination of tissues and discharge (if any) from the deformed nipple. Only after making sure that there is no oncology can you go to a plastic surgeon who will correct inverted nipples.
Stages of nipple inversion
There are three stages of nipple inversion. Belonging to one of the stages depends on the degree of confluence and mobility of the nipples.
- Stage 1. The person can easily pull out the nipple, which then remains in an extended position for some time. Stimulation and breastfeeding also help the nipple emerge from the breast.
- Stage 2: The person can pull out the nipple, but not as easily. After stretching, the nipple tries to return to the breast. This condition may cause difficulties during breastfeeding.
- Stage 3: The person cannot extend the nipple. Even if this can be done, the nipple immediately returns to its original position. With this condition, women may experience serious difficulties while breastfeeding.
Baby feeding rules
You should only put your baby to the breast when he has his mouth fully open. The baby should grasp the entire areola, not just one nipple. The mother's hands should remain free so that she can help the baby. Before applying, it is advisable to do a little pumping to soften the breast and stimulate the nipple with self-massage, a breast pump, or a vacuum.
At the first failures, you need to be patient and under no circumstances refuse to feed your baby. With each attempt the situation will change towards improvement. When feeding, mandatory tactile contact between mother and baby is necessary. This stimulates the searching-sucking reflex in the baby.
Milk leaks should be carefully wiped with a soft cloth so that the baby’s lips do not slip off. The baby clearly picks up the mother’s emotions, so 15 minutes before feeding you need to take the baby in your arms to create emotional comfort for him.
It may also help:
- Hoffman's massage technique - rhythmically squeezing the nipples with your thumbs vertically and horizontally. This is followed by careful pulling it out with varying strength. The pulling process occurs slowly and can take from six months to several years, because in this case, the constricting fibrinous adhesions are destroyed.
- Erotic massage. During sex, you can ask your partner to stimulate the nipple orally or with your hands, especially a few minutes before orgasm.
- Using a breast pump. It helps to evert squeezed tissues; it can be used during pregnancy or breastfeeding.
- Using an injection syringe. It resembles a breast pump. A 10 gram syringe is used with the cut end at level “0”. The movements of its piston will also help stretch the nipple. Pulling should be carried out until pain appears. You need to hold the nipple for no more than 5 minutes.
- Silicone shells - they can only be used before pregnancy. Otherwise, they can lead to premature birth. You can wear them for 1.5-2 hours a day.
- Silicone nipple covers. They make it easier to put the baby to the breast, because... perform stretching. But they can reduce a woman's lactation. A vacuum attachment (vacuumator) is also used. Special suction cups are placed on the breasts, they are connected to a vacuum and fixed with a plaster. When the mechanism is turned on, air is sucked out and drawn out. The attachments are not removed for 2 weeks, but the condition of the skin of the gland is constantly monitored to prevent the formation of cracks, injury, etc. This method is aimed at gradually lengthening the milk ducts and releasing the nipple. With this method, the milk ducts are developed. The disadvantage is its low efficiency. For true inversion, this method is ineffective. With it, only the surgical method is used.
The surgical method is characterized by plastic surgery. If pregnancy is not planned, the nipple tissue is cut and the internal fibers (milky ducts) are lengthened. If pregnancy is planned, a small section of the nipple and areola stroma is dissected through micro-operation. The Milky Ways are not touched. The operation lasts about an hour, under anesthesia or general anesthesia.
During the rehabilitation period, insolation, thermal procedures, and increased physical activity are not recommended.
Effect on breastfeeding
Inverted nipples usually do not become a serious problem when feeding a baby.
While inverted nipples can be challenging, babies can usually feed from them by grasping the areola and pressing it against the roof of their mouth. That is, in most cases, with sunken nipples, women retain the ability to breastfeed.
In addition, it should be noted that nipple stimulation often causes partial nipple release. To achieve this effect, nursing mothers can use a variety of techniques.
Some women find that their inverted nipples begin to emerge gradually during pregnancy and breastfeeding.
Diagnostic methods
The appearance of the formation in question may not indicate polythelia, in which the formation lacks a characteristic shape and signs. This is due to the fact that the 3rd nipple very often does not reach full development. More often, neoplasms are not recognized as polythelia if they are located on the abdomen or groin.
The phenomenon under consideration develops completely rarely. But there are people for whom such education is the norm (Navajo people). Women of this nationality are born with three nipples located in the armpit.
With polythelia, there are three nipples, but no rudiment of an additional mammary gland. When an underdeveloped nipple occurs in women, it does not change during pregnancy. But an additional mammary gland can secrete milk. Unlike physiologically normal ones, the 3rd nipple does not represent an erogenous zone.
