An inverted nipple retracts inward, rather than projecting outward. This common anatomical variation can affect one or both breasts and is often harmless.
What is Nipple Inversion?
Nipple inversion describes a nipple that is pulled inward or lies flat against the areola. This differs from a nipple that consistently protrudes. In some instances, a nipple might be temporarily pulled inward but can emerge with stimulation or changes in temperature, a phenomenon known as retraction.
Nipple inversion is categorized into two main types: congenital and acquired. Congenital inversion is present from birth or develops during puberty, typically due to inherited anatomical factors. Acquired nipple inversion develops later in life and may warrant medical attention, as it can sometimes signal an underlying health condition. Approximately 10% to 20% of the general population experiences some degree of nipple inversion.
Common Reasons for Nipple Inversion
Nipple inversion most frequently arises from benign anatomical variations or normal bodily changes. Congenital inversion can result from short milk ducts, fibrous tissue tethering the nipple inward, or underdeveloped nipple tissue. These variations are generally not associated with health concerns.
Acquired nipple inversion can develop from several non-concerning reasons. Aging can lead to natural changes in breast tissue elasticity, causing nipples to retract as milk ducts may shorten. Past or present inflammation, such as mastitis or other breast infections, can create scarring that pulls the nipple inward. Significant weight fluctuations, particularly sudden weight loss, can also alter breast tissue and lead to inversion.
Another benign acquired cause is mammary duct ectasia, a condition where milk ducts beneath the nipple widen and can become clogged, leading to nipple retraction. Trauma or previous breast surgery can also result in scarring that contributes to nipple inversion. While most cases of nipple inversion are benign, new or worsening inversion can occasionally be a symptom of underlying conditions that require medical evaluation.
When to Seek Medical Advice
Seek medical advice if nipple inversion develops suddenly or changes in appearance. A new onset of inversion, especially if it occurs in only one nipple (unilateral) or if the nipple was previously everted, is a key indicator for concern.
Additional signs warranting prompt medical attention include skin dimpling, redness, or discharge (especially bloody).
A new lump, pain, or alterations in breast size or shape alongside nipple inversion also requires immediate evaluation.
If the nipple cannot be pulled out with gentle pressure and remains fixed, this also suggests the need for medical consultation. A healthcare professional can determine the cause through examination and diagnostic tests like mammography, ultrasound, or biopsy.
Addressing Nipple Inversion
For benign and stable nipple inversion, especially congenital cases, no treatment is necessary. Intervention is considered if the inversion causes physical discomfort, affects breastfeeding, or is a cosmetic concern.
Non-surgical approaches can help evert nipples for cosmetic reasons or to aid in breastfeeding. These methods include manual eversion techniques, such as the Hoffman technique, where gentle pressure is applied around the nipple to encourage protrusion. Suction devices or nipple cups are also available to gently draw the nipple outward over time. For new mothers, lactation consultants can provide guidance and tools to assist with latching.
Surgical correction is an option for persistent or severe nipple inversion, or when non-surgical methods are ineffective. Procedures aim to release fibrous tissues or shortened milk ducts that tether the nipple inward. Some surgical techniques may affect milk ducts, potentially impacting future breastfeeding ability. If an underlying medical condition causes the inversion, treating that condition is the primary focus.