Inverted or retracted nipples represent a common variant of nipples. Usually develop during puberty, but sometimes you might have been born with inverted nipples. It is common as up to 10% of the women have inverted nipples, and it occurs in men too.
Although inverted nipples do not affect your health, it causes psychological distress and a lack of confidence for women and men. There are a variety of correctional methods for inverted or retracted nipples you can use, ranging from small appliances at home to plastic surgery wards.
What is inverted nipple meaning?
Inverted nipples mean that the nipple points inward instead of pointing outward, this happens due to the retraction of the nipples by deep breast tissues, usually the milk duct behind the nipples. In most cases, inverted nipples do not affect sensation or breastfeeding.
Some experts differentiate between retracted which means that the nipple is flat, while inverted means that the nipple is deeply indented instead of pointing outward.
Causes of inverted or retracted nipples
There are multiple causes for inverted nipples like:
- Congenital: the nipples are inverted since birth
- Mammary duct ectasia: inflammation of milk ducts which happens near menopause
- Mastitis: which is an infection of the breast usually after delivery or during breastfeeding
- Trauma: to the breast may cause damage and scarring
- Cancer: causing damage to breast tissue
- Fibroadenoma: benign tumor causing lumps in the breast
How to fix an inverted nipple?
In most cases, inverted nipples do not require any intervention. However, in some cases, the appearance of the retracted nipple causes low self-esteem, and treating this condition for aesthetic purposes helps. Also, inverted nipples may interfere or even prevent breastfeeding.
According to the severity of nipples inversion, the cases are classified into three grades:
- Grade I: the inverted nipples are easily pulled and projected, and this can last for a while. In this grade breastfeeding is not a problem and as it is believed to have minimal fibrosis, it can be fixed by non-surgical procedures.
- Grade II: the inverted nipples can be pulled but it retracts right back and cannot hold its shape.in this grade, the fibrosis is intermediate, though it may slightly interfere with breastfeeding and they may benefit from surgical correction.
- Grade III: in this grade, the nipples cannot be pulled and requires surgical intervention to fix
How to fix an inverted nipple without surgery?
Retracted or invaginated nipples are not an unsolvable issue. Many may resolve their inverted nipples without surgery. Before moving to see which technique fits you more, you must examine your breast to know your inverted nipples grade. And examine both breasts as sometimes you may have different grades or even only one breast with an inverted nipple and the other is normal.
To determine your nipple grade of inversion:
- Examine your unclothed breast in front of a mirror
- Apply gentle but firm pressure on your nipple
- Notice the behavior of your nipples
According to nipples shape and behavior, you can easily classify your condition
- Grade I: your nipples projected when touched and kept its shape
- Grade II: your nipples took time to project and lost its shape immediately
- Grade III: your nipples did not project
After determining your nipple grade, you need to know the cause of your condition, as it may affect the chosen technique to reverse your problem.
- If you may have noticed this change in your nipples recently and developed quickly with other breast changes such as pink discharge, thickening of your breast skin, you should seek medical consultation immediately.
- If you are near menopause and noticed nipple redness and tenderness, you may have mammary duct ectasia and need to consult a medical expert first.
- If you are breastfeeding and have a fever, breast tenderness, and change in your breast color, you may have an infection or breast abscess. Treating this condition first may resolve your retracted nipples spontaneously.
Now, here are some techniques you can try at home. Though it may take time to show results, you should begin slowly and increase by time to get the best results.
Inverted nipples solutions
1)The Hoffman technique: this technique gives the best results in grade one and two as they have the minimal fibrosis that can loosen up by these repetitive movements
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- this technique is suitable for grade I&II
- Apply pressure by both of your thumbs at the base of your nipple
- Move your thumbs at the opposite direction
- Repeat in all directions
- Begin with once per day then increase to reach up to five times per day
2) The rolling technique: this technique when it is used frequently, may help in reversing the retracted nipple
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- Apply a cold pack or wet cloth to your breast to stimulate your nipple
- Roll your nipple between your thumb and finger
- Manipulate and move your nipple in all directions
- Do it several times per day
3) Breast shells: also known as breast shields or breast cups. Was designed to help new moms with flat or inverted nipples breastfeed their infants.
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- They are round shape cup made of plastic with a hole in the middle to fit your nipples in
- Wear breast shells under your clothes
- It works by applying pressure on deep breast tissue and loosens the fibrosis that keeps the nipples from protrusions.
4) Breast pumps: this device is used to pull out the inverted nipple especially for pregnant or breastfeeding mothers.
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- Start to use a breast pump to project your nipple during pregnancy
- Use it on its highest strength but keep yourself comfortable without pain
5) Inverted syringe method: this technique if used properly and frequently, may help to decrease deep tissue adhesions, thus helps elongate the nipple.
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- Use a clean needle without its syringe and choose a suitable size for your nipple and cuts the end
- Fit your nipple slowly in the opening and start moving the plunger
- Keep yourself comfortable
- There is a device working with the same technique to make it easier
6) Niplette: though niplette was designed to help women with inverted nipples to breastfeed, anyone with retracted nipples can use it with allegedly permanent results
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- Wear under your clothes
- At first, use it for one hour per day, then gradually you can use it up to eight hours per day
- Results of everyday use may appear in three months
7) Supple cup: this small plastic cup-like device work by the suction of the nipple into the cup
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- It comes in sizes, your size depends on your nipples size and your inverted nipple grade
- It was used in some clinical studies that prove good results of supple cups
- In some cases, continuous use reduced the grade of inverted nipple i.e. grade two become grade one
Inverted nipple piercing:
piercing at the base of the nipples and putting on a piece of jewelry can help retracted nipples to be erect and hold their shape. This technique gives quick and efficient results especially if done by a specialist in an inverted nipple piercing or medical professional.
The nipple piercing Can replace surgery especially in grade I&II and Prevents nipples retraction in most cases. For grade III, there is a high failure rate and nipples return inverted in many cases.
The healing process may take between four months to one year. And piercing Does not prevent breastfeeding but with many precautions to prevent the baby choking or infection to the piercing site or baby.
All piercings Should be kept clean to prevent complications like pain and infection. And in some cases, their nipples may return inverted as before piercings.
There are no sufficient clinical studies were performed to monitor long-term effect and results of inverted nipples piercings, and if the nipple maintained its shape after piercing removal.
Surgical correction of inverted nipples
Many methods and devices promote pulling out the inverted nipples, but in most cases, these devices or techniques do not resolve the underlying reason, eventually, the problem will be persisted.
Surgical correction of the retracted nipples may provide the permanent solution and for severe cases maybe it is the only solution there.
There are multiple surgical techniques for correcting the inverted nipples, but all these techniques aim at cutting the fibrous tissue band that pulls the nipples inward.
The difference between these techniques is that some surgeons try to preserve the lactiferous duct intact, which can make breastfeeding later possible.
Surgical correction of inverted nipples is an outpatient clinic procedure, can be done under local anesthesia, with fast recovery time ranging from two to three weeks.
Like any surgical procedure, there is a risk for developing complications like:
- Infection
- Loss of sensation of the nipples
- Marked scarring of nipples and areola
- Destroying breast tissue which may lead to the inability to breastfeed
Inverted nipple and breast cancer
You may find a newly inverted nipple is worrisome, but keep in mind that not all inverted nipples mean you have breast cancer, there are broad differentials to refracted nipples.
Other symptoms of breast cancer may include a lump or thickening in your breast, color-changing of breast skin, oozing nipples, and scaling.
The cause of inverted nipples in breast cancer is the cancerous lesions destroy the breast tissues especially the duct behind the nipples.
Inform your physician about any change you notice in your nipples or breast, family history, and complete physical examination is needed to evaluate your condition, further investigations may include breast ultrasound, mammogram, fine needle aspiration, and biopsy.
The most common breast cancer that affects nipples is Paget’s disease of the nipples and duct carcinoma.
Early detection of breast cancer and starting treatment promptly obtain better outcomes in the long term.
Inverted nipples and breastfeeding
Inverted nipples are a common problem between women, though it does not carry serious health problems, for a pregnant woman the important question is “can I breastfeed my baby normally?”.
And the answer is yes, for most cases of inverted nipples, there is not a problem in breastfeeding. It may be challenging but not impossible and gets easier by time.
For the baby to suckle, he must latch properly on the whole areola. This makes the shape of the nipple not crucial for him. For his mother, this may hurt.
Tips for breastfeeding with flat or inverted nipples
- Start preparing your nipples while pregnant. Though controversial, some experts recommend wearing nipple former in the last weeks of pregnancy to help pull nipples out.
- Before each feed, you must stimulate your nipples to protrude. You can do it by applying a cold towel to your breast or manipulating your nipples by hand gently.
- Use one of the nipple protrusion devices that help you keep your nipple erect.
- Use a breast pump before each feed to stimulate your nipple and to help your baby to latch.
- Use nipple shields as it can make breastfeeding easier for mothers with inverted nipples.
- Find a lactation consultant locally for support especially in the first few weeks of breastfeeding.
- Note that nipples piercing usually do not interfere with breastfeeding, but you should be cautious with
- Remove your piercing every feed to prevent choking hazards
- Piercing should be kept clean to prevent infection for you and your baby
- Keep your nipples dry all the time to prevent cracks and infections.
- Continuous and repeated breastfeeding can improve your nipples’ conditions and make lactations better.
Inverted nipples in men
Inverted nipples occur in men as in women, nearly 10% of the men population have inverted or flat nipples. And the cause of this condition is as in women, a fibrous tissue in breast tissue that pulls the nipple inward. Or secondary to gynecomastia, in which enlargement of mammary glands is the cause of the problem.
Some experts recommend nipples piercing for aesthetic reasons only. But still, the permanent cure is in plastic correction surgery with swifter recovery for men than women.
Remember, inverted nipples are not a defect, it is a normal variant and does not carry any harmful effect on your health or normal functions.
According to genetics experts, your nipples are inverted because your genes decided that. And they are common in women and men too.
Do not panic over your inverted nipples, as this does not mean you have cancer, but if these changes happened recently or accompanied with other breast changes, seek medical advice
And finally, if you do not like the shape of your nipples, there are a lot of available solutions and you can choose what is best for you.