Table of ContentsView AllTable of ContentsDefinitionSymptomsCausesNipple Shapes and SizesTreatmentComplicationsDiagnosisWhen to See a Provider
Table of ContentsView All
View All
Table of Contents
Definition
Symptoms
Causes
Nipple Shapes and Sizes
Treatment
Complications
Diagnosis
When to See a Provider
Nipples that point inward or lie flat against theareolaare called inverted or retracted nipples. Inverted nipples affect women and men and are eithercongenital(present at birth) or acquired.
Although inverted nipples are usually harmless, they can be related to serious health conditions in some cases. If you experience a sudden inversion of one or both nipples, you should contact your healthcare provider as soon as possible.
This article discusses the symptoms, causes, and treatment for inverted nipples.
Jelena Stanojkovic / Getty Images
What Are Inverted Nipples?
Most nipples protrude outward from the breast. Inverted nipples are “tucked” inward or appear flush with the areola instead of protruding outward. Inverted nipples affect 2% to 10% of women and are usually bilateral (in both breasts).The only thing that physically differentiates inverted nipples from the more common protruding nipples is how they look.
Grades of Nipple Inversion
Inverted nipples are assigned a grade according to the degree to which they are inverted:
All About Nipples: Pointy, Flat, Inverted, and More
Causes of Inverted Nipples
Tight milk ducts and connective tissue under the nipples usually cause the inversion. New or sudden nipple inversion can occur with infection, breast injury, or invasive and noninvasive cancers.
Born With Inverted Nipples
Most people with inverted nipples are born with them (congenital). Tight or insufficient connective tissue around the nіpple or problems with theductal systemunder the nipple are characteristics of congenital nipple inversion.
Age
With age, breasts change shape naturally, becoming more flat or retracted as you get older. Because milk ducts shorten during peri-menopause and menopause, this may cause the nipples to retract into your body.
Because breast cancer risk increases with age, consult your healthcare provider whenever you notice a change in your breasts.
Breastfeeding
Pregnancy and breastfeeding can be a cause of nipple inversion. Your nipples may flatten as your breasts fill with milk during and after pregnancy. The condition usually resolves once breastfeeding has ended.
Inverted Nipples and BreastfeedingFor those with inverted nipples prior to pregnancy, the condition can sometimes reverse naturally during pregnancy and breastfeeding. If not, inverted nipples can make breastfeeding difficult, although those with grade 1 or 2 inversions usually breastfeed successfully.Nipple stimulation techniques can help to extend the nipples outward, so work with your healthcare provider or a lactation consultant to make breastfeeding easier.
Inverted Nipples and Breastfeeding
For those with inverted nipples prior to pregnancy, the condition can sometimes reverse naturally during pregnancy and breastfeeding. If not, inverted nipples can make breastfeeding difficult, although those with grade 1 or 2 inversions usually breastfeed successfully.Nipple stimulation techniques can help to extend the nipples outward, so work with your healthcare provider or a lactation consultant to make breastfeeding easier.
For those with inverted nipples prior to pregnancy, the condition can sometimes reverse naturally during pregnancy and breastfeeding. If not, inverted nipples can make breastfeeding difficult, although those with grade 1 or 2 inversions usually breastfeed successfully.
Nipple stimulation techniques can help to extend the nipples outward, so work with your healthcare provider or a lactation consultant to make breastfeeding easier.
Blocked Milk Ducts
Fluid buildup in the milk ducts can cause the breasts to become tight, pulling the nipples inward. Conditions like an abscess,mammary duct ectasia, andmastitiscan block milk ducts.
Breast Injury or Surgery
Scarred milk ducts frombreast fat necrosis,breast reduction surgery, andnipple piercingscan cause inverted nipples.
Paget’s Disease of the Breast
Paget’sdiseaseis a rare cancer that develops on the skin of the nipple and areola.
Paget’s disease is often mistaken foreczemaand causes symptoms, such as:
People with Paget’s disease usually also haveductal carcinoma in situ (DCIS)orinvasive breast cancerinside the same breast and may be able to feel a lump.
Are Inverted Nipples a Sign of Breast Cancer?
Breast Cancer
While a flat or inverted nipple rarely indicates breast cancer, it can sometimes be a symptom. Inversion may happen when a breast tumor invades the milk duct, or when cancer cells affect the nipple itself (Paget’s disease). Nipple inversion usually develops suddenly and may coincide with other breast changes.
Breast Cancer Symptoms
Abcess Under the Areola
Asubareolarnipple abscessis a pocket of pus that develops beneath the nipple or areola. An abscess forms when bacteria enter the skin and cause inflammation and swelling. The abscess fills with pus—a thick, whitish-yellow fluid made up of dead/living bacteria, white blood cells, and tissue debris. An abscess may cause a lump, pain, and/or produce drainage.
Is It Normal to Have Inverted Nipples?
Healthy nipples present in a variety of sizes or shapes. As mentioned, inverted nipples are fairly common, and it is typically a harmless condition and not a cause for concern.
How to Treat Inverted Nipples
Treatment for inverted nipples depends on the cause of the condition. If the inversion is congenital, surgical approaches are available to improve the appearance and function of the nipples.
Hoffman’s Technique
Surgery
Several types of surgical techniques can correct inverted nipples. The most effective procedure depends on your unique situation.
Inverted nipple repairis performed under local anesthesia. A small incision is made underneath the lower end of the nipple to lift surrounding tissue. The tissue is then reshaped into a protruding nipple.Complementary procedures include areola reduction,breast augmentation, and breast reduction.
Nipple Eversion Devices
Nipple eversion devices are designed to promote nipple protrusion. They include breast shells, cups, and extractors (e.g., Niplette, Pippetop, Medela SoftShells, and Supple Cups).
When used over time, these devices may help to loosen nipple tissue and allow longer periods of nipple erection.
Piercings
Nipple piercing is intended to help inverted nipples to protrude more. The jewelry worn in the piercing functions to keep the nipple erect. Piercing is not effective for everyone with nipple inversion, and those who plan on breastfeeding should not pierce their nipples.
Complications and Risk Factors
Risk factors for developing inverted nipples are family history and aging. The following are complications of having inverted nipples:
If you have inverted nipples and are experiencing any of the above complications, reach out to your healthcare provider for guidance.
Are There Tests to Diagnose the Cause of Inverted Nipples?
Your healthcare provider can use a variety of tests to diagnose the cause of inverted nipples. The tests may include the following:
When to See a Healthcare Provider
Any new or sudden changes to your nipples should be immediately reported to your healthcare provider, including:
Summary
Inverted or retracted nipples point inward instead of protruding out. The most common cause of inverted nipples is congenital, meaning you are born with them, but some people may acquire inverted nipples due to aging, infection, breast injuries, or cancer.
Although usually harmless, inverted nipples can lead to functional, psychological, and aesthetic consequences. There are surgical procedures that can improve inverted nipples. If you have any new or sudden changes in the appearance of your nipples, notify your healthcare provider immediately.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mangialardi ML, Baldelli I, Salgarello M, Raposio E.Surgical correction of inverted nipples.Plast Reconstr Surg Glob Open. 2020;8(7):e2971. doi:10.1097/GOX.0000000000002971American Cancer Society.Paget Disease of the Breast.Jeong HS, Lee HK.Correction of inverted nipple using subcutaneous turn-over flaps to create a tent suspension-like effect.PLoS One. 2015;10(7):e0133588. doi:10.1371/journal.pone.0133588Breastfeeding Support.Breastfeeding With Inverted Nipples and Flat Nipples.Washington University in St. Louis.Inverted Nipple Correction.The American College of Obstetricians and Gynecologists.Benign breast conditions.MedlinePlus.Breast skin and nipple changes.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mangialardi ML, Baldelli I, Salgarello M, Raposio E.Surgical correction of inverted nipples.Plast Reconstr Surg Glob Open. 2020;8(7):e2971. doi:10.1097/GOX.0000000000002971American Cancer Society.Paget Disease of the Breast.Jeong HS, Lee HK.Correction of inverted nipple using subcutaneous turn-over flaps to create a tent suspension-like effect.PLoS One. 2015;10(7):e0133588. doi:10.1371/journal.pone.0133588Breastfeeding Support.Breastfeeding With Inverted Nipples and Flat Nipples.Washington University in St. Louis.Inverted Nipple Correction.The American College of Obstetricians and Gynecologists.Benign breast conditions.MedlinePlus.Breast skin and nipple changes.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Mangialardi ML, Baldelli I, Salgarello M, Raposio E.Surgical correction of inverted nipples.Plast Reconstr Surg Glob Open. 2020;8(7):e2971. doi:10.1097/GOX.0000000000002971American Cancer Society.Paget Disease of the Breast.Jeong HS, Lee HK.Correction of inverted nipple using subcutaneous turn-over flaps to create a tent suspension-like effect.PLoS One. 2015;10(7):e0133588. doi:10.1371/journal.pone.0133588Breastfeeding Support.Breastfeeding With Inverted Nipples and Flat Nipples.Washington University in St. Louis.Inverted Nipple Correction.The American College of Obstetricians and Gynecologists.Benign breast conditions.MedlinePlus.Breast skin and nipple changes.
Mangialardi ML, Baldelli I, Salgarello M, Raposio E.Surgical correction of inverted nipples.Plast Reconstr Surg Glob Open. 2020;8(7):e2971. doi:10.1097/GOX.0000000000002971
American Cancer Society.Paget Disease of the Breast.
Jeong HS, Lee HK.Correction of inverted nipple using subcutaneous turn-over flaps to create a tent suspension-like effect.PLoS One. 2015;10(7):e0133588. doi:10.1371/journal.pone.0133588
Breastfeeding Support.Breastfeeding With Inverted Nipples and Flat Nipples.
Washington University in St. Louis.Inverted Nipple Correction.
The American College of Obstetricians and Gynecologists.Benign breast conditions.
MedlinePlus.Breast skin and nipple changes.
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