Inverted Nipple: Causes and Treatment

Overview

In cases of an inverted nipple, it retracts within when it’s inverted, instead of protruding normally. Inverted nipples resulting from developmental anomalies, also known as congenital inverted nipples, are typically asymptomatic. For the individual with an inverted nipple, however, the look might lead to psychological issues. It may also result in possible nursing problems.

Around 10% of people have inverted nipples, which can affect people of either gender. In addition, 10-20% of newborn girls have at least one inverted nipple. Inverted nipples obtained as a consequence of a medical condition may cause further problems. In the event of an unexpected development of an inverted nipple situation, medical advice should be taken.

What is an Inverted Nipple?

A nipple that has been inverted and points inward toward the breast is referred to as an inverted nipple. It is also retractable, allowing it to rest flat against the areola—the ring of skin surrounding the nipple that is pigmented.

An inverted nipple can occur on one or both breasts in men and women. Inversion occurs in around 2% of nipples and is usually acquired since birth.

Grades of Inverted Nipple

Based on the level of fibrosis, manageability, and harm, medical professionals classify inverted nipples into three groups. There are three classifications of inverted nipples:

• • Grade 1: Inverted nipples with little to no fibrosis are categorised in grade 1 of inverted nipples. They also continue to have enough soft tissue. Even with the nipple retracting, the milk ducts are usually normal. Nursing becomes simpler when necessary since the nipples are simple to control.
  • Grade 2: There is mild fibrosis in this grade of inverted nipple. The fibrous stroma is usually encased in smooth bundles. The milk ducts don’t get disturbed even while retracted. The nipple can be pulled out, although it usually retracts fast after that. It can be tedious to breastfeed as the infant might experience difficulty latching.

• Grade 3: The soft tissue is very deficient and exhibits significant fibrosis in this grade. The milk ducts seem to have narrowed and retracted significantly. It is usually difficult to nurse, and it is impossible to take the nipples out. Other symptoms such as dermatitis, painful nipples, and recurrent mastitis may also accompany this grade.

Causes of Inverted Nipples

One of the most frequent reasons for an inverted nipple is genetics. Most breast development happens in the womb around the ninth month of pregnancy when a pit develops at the mammary bud’s epidermis. The mesoderm underneath the pit expands and rises over the areola as tubes and holes form inside it. It is this phase of growth that results in a nipple. An inverted nipple can arise from the mesoderm failing to ascend over the areola due to a variation in the aforementioned development process.

Later in age, an inverted nipple can also develop as a result of certain diseases. Other causes are:

• Duct Ectasia: When the walls of the breast duct thicken and expand, duct ectasia occurs, a noncancerous disorder. This may obstruct the milk duct and cause an accumulation of fluid. While duct ectasia can occur at any age, it is more frequent in women who are nearing menopause. Duct ectasia frequently exhibits no symptoms. In some situations, the issue can only be discovered via a biopsy conducted by a medical practitioner for a different breast ailment. However, when they do occur, symptoms might include heavy, sticky discharge from the nipples, soreness in the surrounding tissue and nipple, and retraction or inversion of the nipples.
• Breast Fat Necrosis: An inflammation of the fat tissue in the breasts caused by a disturbance in the oxygen supply to the fat cells is known as breast fat necrosis. Finally, the cells may die as a result of this. Female breast procedure patients frequently get necrosis of the breast tissue. It might also be a sign of breast cancer, though. The most frequent reason for non-surgical patients is breast trauma. Breast fat necrosis manifests as breast mass alterations, breast lumps, breast inversion, and skin tightness. Distinguishing between breast cancer and necrosis of breast fat might be challenging. A quick consultation with the doctor is suggested if experiencing any signs of breast fat necrosis.
• Acute Mastitis:  Inflammation of the breast tissue is known as acute mastitis. Two types of mastitis exist:

1. Lactational Mastitis
2. Non-lactation Mastitis

Acute mastitis is a prevalent ailment among nursing professionals. Even if a pregnant woman is not breastfeeding, mastitis still can occur. This is significantly less typical, though.

Other causes of inverted nipples are:

• Breast cancer
• Aging
• Breast sagging
• Tuberculosis
• Abscess
• Surgery or any other type of breast trauma
• Paget disease

Treatment for Inverted Nipples

Any concerns or treatment options should be discussed with the doctor in detail. The line of treatment relies on the degree of inversion.

• Hoffman method: To prepare for a healthy nursing experience, this exercise may be helpful if the nipples are flat or slightly inverted. Pressing down and drawing the thumbs apart, while positioning thumbs on either side of the nipple’s base. The nipple should be touched on all sides while performing this exercise. At this point, the nipple ought to be prominent.
• Devices for eversion of the breasts: Using a syringe or suction cup equipment, the doctor could advise drawing the nipple outward. The nipple is forced forward by the pressure of hard plastic breast shells within the bra that surround it.
• Medical procedures: Most cases of inverted nipples are treated with surgery. The possibility of surgery harming milk ducts should be discussed with the surgeon if planning to breastfeed in the future. It should be noted that some nipples revert to their original position even following surgery.

Conclusion

Nipple inversion is among the most prevalent breast variants. However, it should have no impact on your health.

Manual stimulation is frequently used to temporarily correct inversion. If something more permanent is desired, a quick consultation with the doctor about nipple piercing and surgical alternatives is advised. They can explain the possible benefits and hazards of each strategy.

Women who are breastfeeding or intend to breastfeed should keep this in mind while considering piercing or surgery as piercings may interfere with the ability to breastfeed, and some procedures may interfere with producing milk. 

Frequently Asked Questions

1. Is it possible to breastfeed with flat or inverted nipples?

Yes, it is possible to breastfeed with a flat or inverted nipple. Your doctor can suggest strategies to move your nipples outward so your baby can latch.

2. When should I see my healthcare provider?

If you detect any unexpected changes in your breast, such as inverted nipples, let your doctor know. This alteration might indicate an underlying problem that requires prompt attention.

3. Are inverted nipples hereditary?

Some research suggests that this condition can run in families, although it is not completely hereditary.

4. Is an inverted nipple a sign of breast cancer?

One indicator of breast cancer may be an inverted nipple. This is particularly true if the inversion is a novel phenomenon that occurs unexpectedly.

To ascertain whether the symptom is caused by cancer or a benign condition, your healthcare provider may recommend certain tests, such as a mammogram, breast ultrasound, breast MRI (magnetic resonance imaging), or biopsy (removing a sample of tissue for analysis in a lab).