An inverted nipple can be a natural condition many women are born with and might resolve naturally during pregnancy or breastfeeding. However, the condition may occur later, sometimes suddenly, due to various causes, including cancer. Nevertheless, you can fix inverted nipples or flat nipples using various correction techniques and solutions such as surgery, nipple piercing, niplette, Hoffman and supple cups. Get insight into the causes of inverted nipples and learn how to get rid of them using various treatments and home remedies (with pictures).
What are Inverted Nipples? Meaning & Definition
An inverted nipple is a condition whereby the nipple is retracted inward into the breast instead of pointing outward. This condition is often referred to as nipple inversion, nipple retraction, or invaginated nipple. Moderately inverted nipples are generally called flat nipples.
In some cases, an inverted nipple may temporarily protrude when it is stimulated. The condition usually affects women but can also occur in men. It can affect one or both of the breasts.
An inverted nipple can be congenital (present at birth) or acquired (develop later after birth). Acquired nipple inversion can result from either to benign or malignant conditions, or due to trauma. It is also common for a baby or child at puberty to develop inverted nipples and this may be considered natural.
Congenital nipple inversion is not a sign of any medical condition and can resolve on its own temporarily or permanently during pregnancy or breastfeeding. On the other hand, having an acquired nipple inversion may be a sign of a more severe medical condition.
Inverted Nipple Pictures
Pictures of inverted nipples or images placed in various relevant sections of this post may help you understand the condition better. Also included are inverted nipple pictures before and after correction (surgery) in a later section of this post.
What Do Inverted Nipples Look Like?
Unlike a normal nipple which protrudes from the breast, an inverted nipple is pulled inward leaving a hollow are in the normal position of the nipple. The retraction of nipples retracts to various degrees as discussed in a later section of this post. This picture compares an inverted nipple and a normal nipple.
Inverted nipples Female
Women tend to be affected more by nipple invasion than men, probably because their breasts are big. This picture gives a typical appearance of inverted female nipples.
Inverted Nipples Male
Nipple invasion in men is fairly rare, probably because of their small size. This picture gives the typical appearance of inverted male nipples.
How common are Inverted Nipples?
How often do inverted nipples occur? It is estimated that about 9 to 10 percent of women have at least one inverted nipple, temporarily or permanently. However, a much lesser proportion of men is affected by the condition.
Inverted Nipple Grading
Inverted nipples are categorized into three grades. The grading of inverted nipples is based on various factors associated with the condition.
- The ease of protracting (pulling out) easily the nipple
- The degree of fibrosis existing in the breast
- The damage the condition has caused on the milk ducts.
Grade 1 Inverted Nipple
Grade 1 inverted nipples can be easily be pulled out by gently applying finger pressure around the areola. Occasionally, Grade 1 inverted nipples may pop up without manipulation or finger pressure. They are often referred to as ‘shy nipples’.
In this grade, milk ducts are usually intact and hence breast feeding is possible. The affected breasts have minimal or no fibrosis at all. There is no soft-tissue deficiency and the lactiferous ducts are undamaged not pulled inward.
Grade 2 Inverted Nipple
Grade 2 inverted nipples are more difficult to pull out than a grade 1. Unlike grade 1, when released, the nipple in grade 2 inversion retracts inward.
In this grade, the lactiferous ducts are mildly retracted and do not need to be cut in order to release the fibrosis. They have a moderate degree of fibrosis.
Grade 3 Inverted Nipple
Grade 3 inverted nipples can rarely be pulled out physically. The nipples are severely retracted and it requires surgery in order to be pulled out.
In this grade, milk ducts are often constricted and breast feeding is not possible. The breast has considerable fibrosis and lactiferous ducts are severely retracted and short.
Due to the fact that the nipples cannot be pulled out, people with Grade 3 inverted nipples may experience problems with nipple hygiene. As a result, they may often get infections and rashes in their nipples or breast.
Inverted nipples Grade Self-test
You can perform a simple pinch test for your nipples to find out which grade they belong to. This test is especially for women.
Just hold your breast around the edge of the areola between your thumb and index finger. Press inward gently but firmly, about an inch behind your nipple.
- If it protrudes easily, it is considered a grade 1 inversion
- If it does hardly protrudes but does not retract, it is considered a grade 2 invasion.
- If it retracts or does not protrude at all, it is considered a grade 3 inversion.
Flat Nipples vs Inverted Nipples
The term ‘flat nipples‘ is also widely used to talk about nipple retraction. However, it is generally used to refer to moderately inverted nipples, specifically grade 1 and grade 2 inversion. Often, those who use it try to distinguish between ‘flat nipples’ (grade 1 and grade 2 inversion) and ‘truly inverted nipples’ (grade 3 inversion).
Therefore, flat nipples are moderately inverted nipples, although the terms are sometimes used interchangeably. For the purpose of our discussion, the term ‘flat nipples’ is used to refer to grade 1 and 2 inverted nipples.
Inverted Nipples Causes
Basically, the factors that cause inverted nipples generally affect the fibrous ligaments that support the nipples in their right position in different ways. As a result, the ligaments then pull the nipples inward. The most common causes of nipple inversion include:
1. Genetic Variation
An inverted nipple retraction can be a congenital condition (present at birth) as a normal variant in some women. Such genetic variant of nipple shape include:
- Weaver syndrome also called Weaver-Smith syndrome
- congenital disorder of glycosylation type 1A & 1 L
- Kennerknecht-Sorgo-Oberhoffer syndrome
Around 10–20% of all women are born with inverted nipples. Common natural nipple variations in women are caused by short ducts or a wide areola muscle sphincter.
2. Aging
Changes that occur in the body due to old age may affect breast tissues such that ligaments pull the nipples inward in a way that may lead to inverted nipples.
3. Trauma
Injuries on breast that may lead to inverted nipples may result from conditions such as breast fat necrosis, physical injury scars or surgery for medical or cosmetic purposes.
4. Breast Sagging
Breast sagging (drooping or Ptosis) may also affect the breast tissues. In case this causes ligaments to pull the nipple inwards, it may result in inverted nipples.
5. Breast cancer
Breast cancer may also cause deformation of the breast and lead to the formation of inverted nipples. Breast cancerous conditions that may cause inverted nipples include:
- Breast carcinoma: This is a form of breast cancer.
- Inflammatory Breast Cancer (IBC): This is an uncommon type of breast cancer that causes the breast to become red, swollen or inflamed.
- Paget’s disease: This is a rare form of cancer that forms in or around the nipple. It usually causes the skin on the nipple area to become red, sore, and scaly.
6. Breast Infections
Various breast infections and inflammations can lead to the formation of inverted nipples. Common such causes include:
- Mastitis (mammitis): This is an inflammation of breast or udder tissue, which is usually caused by an infection
- Breast abscess: This refers to a painful collection of pus that usually forms under the skin of the breast due to a bacterial infection.
- Mammary duct ectasia: This is a condition in which the lactiferous duct becomes blocked or clogged. This condition may be caused by smoking.
- Tuberculosis (TB): This is a bacterial infection. Although it generally affects the lungs, it can also affect other body parts and if the breast is involved, the nipples may become inverted.
7. Breast Cyst
A cyst in breast is a harmless benign sac filled with fluid and may feel like a lump in the breast. A breast cyst may cause inverted nipples, especially if it forms under or near the nipple.
8. Benign Breast Tumors
The common benign tumors (non-cancerous growths) in the breast that can cause inverted nipples include:
- Fibroadenoma: This is a common noncancerous tumor that develops in the breast and is composed of both glandular breast tissue and stromal (connective) tissue.
- Intraductal Papilloma: This is a small non-cancerous tumor that forms in a milk duct in the breast. it is composed of both gland tissue and fibrous tissue and blood vessels.
9. Breast Duct Ectasia
This is a condition that occurs when a milk duct beneath the nipple widens, the walls of the duct thicken and the duct becomes filled with a fluid. This condition can lead to inverted nipples.
10. Gynecomastia
This may cause of cause of inverted nipples in men. It is a common disorder in male breasts that causes a non-cancerous size increase of male breast tissue.
11. Weight loss
Sudden and major weight loss can also lead to inverted nipples This is because such an occurrence may cause interference with the fibrous ligaments supporting the nipples, making the nipples to retract.
12. Others Causes
Other conditions such as monocytosis may also cause inverted nipples in both men and women if the conditions affect the breast area.
Inverted Nipples Cancer
Although cancer is a rare cause of inverted nipples, it is vital to go for a checkup when as soon as you realize that you are developing inverted nipples.
This measure applies only to those who were not born with the inverted nipples. This measure will enable doctors to either rule out breast cancer or confirm it. If confirmed, it will be easier, cheaper and less painful to treat it.
On the contrary, if breast cancer is discovered later at an advanced stage, it may be painful, expensive and difficult to treat. In some cases, it may cause a serious damage to your breast or even be incurable and hence fatal.
Sudden Inverted Nipples
Sudden inverted nipple may be an indication of a more serious health problem in your breast, unless it is associated with pregnancy or breastfeeding. See your doctor in case your nipple suddenly become inverted without any apparent reasons known to you.
On and off Inverted Nipples
Whereas some people experience permanent nipple inversion, other may experience them during some periods and no other. This depends on particular individuals and probably the cause.
In some cases, some individuals may find that nipples that once seemed permanently inverted now fluctuate between inverted and erect in different times.
Many women experience inverted nipples during pregnancy, even when their nipples normal before weren’t inverted pregnancy. This behavior of nipples tends to affect first-time pregnant women than women with subsequent pregnancies.
Inverted Nipples and Pregnancy
In some cases, Inverted nipples may resolve naturally during pregnancy. This especially happens with women who were born with the condition. Their nipples come out temporarily (usually until the end of breastfeeding period) or permanently because of body changes during pregnancy, or as a result of breastfeeding.
Inverted Nipples and Breastfeeding
Like in pregnancy, inverted nipples may temporarily or permanently resolve during breastfeeding period. However, this usually occurs only if the woman was naturally born with the condition. Acquired inverted nipples may require a medical for correction.
After giving birth, most women with inverted nipples are able to breastfeed without complication. However, but inexperienced mothers (first-time mothers) may experience some pain and soreness, especially at the beginning of breastfeeding.
With the right breastfeeding, the baby should latch on the areola (the area around the nipple) and not the nipple itself. Therefore, it is possible for mothers with inverted nipples to actually able to breastfeed without any problem if they understand the right technique of breastfeeding.
If an infant is able to latch on well it will be able to slush out an inverted nipple and suck normally. However, if this is not possible a breast pump or other suction device may be used just before breastfeeding to help to draw out inverted nipples.
Alternatively, a mother with inverted nipples can use a nipple shield to aid breastfeeding. Also, sexual stimulation such as nipple sucking can help draw out the nipples before a breastfeeding session.
How to get Rid of Inverted Nipples or Flat Nipples
Having inverted nipples may be a cosmetic issue, especially to women, who may think they might turn off their partners. However, grade 3 nipple inversion may be both a cosmetic and medical problem because the mother may not be able to breastfeed the child.
Therefore, many people, especially women, may go for inverted nipple correction for medical or cosmetic reasons, or both. There are both inverted nipple correction with or without surgery.
Generally, grade 1 and 2 nipple inversion may be corrected with non-surgical methods but grade 3 nipple inversion usually requires surgical procedures. However, grades 1 and 2 nipple inversions (flat nipples) may still be corrected by surgical means.
In general, non-surgical nipple inversion procedures can be done at home as home remedies but surgical procedures are done in office by experienced breast surgery experts. Never subject your breasts to risks by allowing inexperienced health practitioners to carry out the surgery
Home Remedies for Inverted Nipples
The home remedies for inverted nipples include Hoffman technique, Suction Techniques and use of nipple clamps.
1. Hoffman technique
Hoffman technique is a method of drawing out inverted nipples by pulling it out and massaging the breast around the areola for several days. Acceding to Heathline.com, this technique has been in use since the 1950s.
Procedure:
- Place each of your thumbs on either side of your nipple. The thumbs should at the base of the nipple within the areola.
- Press firmly into your breast tissue, ensuring that you are giving the nipple adequate space to come out.
- While still pressing down on the breast, gently draw the thumbs away from each other.
- Continue to move your thumbs all around the nipple while still applying pressure to the breast.
- Repeat this procedure at least once per day for several days.
Note: It is not clear how long this effect will last. Regular stimulation may help your nipples protrude more often. The technique may work easily for some individuals but even fail in others. In case the technique fails to work for you, just know that everyone’s breasts are different. In any case, there are currently no studies to prove that the effectiveness of this technique
2. Suction Technique
This technique involves the use of specially designed suction devices to solve nipple inversion problem. There are various suction devices that can be used to reverse inverted nipples. These devices are usually worn under clothing for a long period of time to produce results.
The suction products are sold under various names including nipple retractors, nipple extractors, breast shells and breast cups. Basically, all the devices usually work by pulling the nipple into a small cup. As a result, the nipple becomes stimulated and protrudes. Popular brands of suction devices include:
- Avent Niplette
- Pippetop Inverted Nipple Protractor
- Medela SoftShells for Inverted Nipples
- Supple Cups
Prolonged use of these devices can help loosen the nipple tissue. This can help your nipples remain erect and protruded for longer periods of time.
- A breast shell is a soft disc with a small hole in the middle that helps push the nipple forward. The shell applies some pressure to the breast to enable the nipple to stay erect inside the small hole.
- A Supple Cup uses a vacuum cup suction technique in which the air is pushed out before placing it around the nipple to pull it out. After pulling the nipple out of the breast, it is left in attached to the breast for about 15 minutes to 4 hours per day. Use it for shorter periods in the first days of the procedure.
- A niplette is a special device that uses a mechanism like that of a syringe. A syringe can be modified at home to perform the same function as a nipple. However, a niplette is designed in such a way that it can be worn on the nipples under the clothes
- A Breast pump has a suction mechanism that pulls out the nipple by sucking. Breast pump for inverted nipple correction resembles those that are used to get breastmilk from the mother and may be manual or electric. Since they are large, breast pumps cannot be worn under clothes.
Note: Suction devices may work for some people but fail in others. However, since most of the devices are not expensive, they may be worth a try. Nevertheless, There no research that has been carried out to study the effectiveness of suction devices.
Get directions on how to use the device you have opted for and let your doctor know when you are breastfeeding in order to give you appropriate advice.
3. Nipple Clamps
Another solution is the use of specially designed nipple clamps that hold the nipple in an erect position, stretching the tissue that causes it to be inverted. They are worn for an extended period a few hours per day. Nipple clamps are also used as sex toys without necessarily fixing inverted nipples.
Medical Treatments for Inverted Nipples
The medical treatments for inverted nipples include nipple piercing and surgery.
1. Nipple Piercing
Nipple piercing can be used to correct an inverted nipple. After piercing, a nipple jewelry is worn to help keep the nipple in a protruding position. This method may only be used to correct mild to moderate nipple inversion (flat nipples)
However, this procedure should strictly be carried out by experienced piercing experts specifically in piercing of inverted nipples for correction. Do not take chances with your breast with anyone or try doing it yourself.
Also, this method will only be effective if the nipple can be temporarily protracted (Grade 1 or grade 2) It is pierced while protruding and then the jewelry may then prevent the nipple from returning to its inverted state. Otherwise, the nipples are likely to retract even with a jewelry.
Nipple piercing effective may not for everyone. Before undergoing this procedure, talk to your doctor and potential piercer about the effectiveness, benefits and risks for your case. From the advice, weigh the matter before getting pierced. The following procedure outlines how to fix Inverted nipples by piercing
Procedure:
- The piercer will clean the breast with a disinfectant to prevent possible infection after piercing.
- The piercer will pull the nipple out completely It should not be pierced while still retracted.
- The piercer will use a gauged needle to thread a piece of jewelry through the nipple, usually a stainless steel ring or a barbell
Note: The piercer may use a local anesthesia topically or by injection before the procedure to minimize pain during the procedure. The jewelry should be kept intact. If you remove it, your nipples may retract and become inverted again.
After nipple piercing, you will need to follow the aftercare directions for fast healing and also to avoid infections on the pierced nipple. During this time, your nipples may become slightly inflamed and achy. This happens especially because the nipple is was forced out and this might also make the actual piercing more painful.
Inverted Nipples Pierced
Here is a picture of an inverted nipple that is pierced for inversion correction.
2. Inverted Nipple Surgery
Inverted nipples can be fixed using plastic surgery correction. You need to go for the surgical correction if you need a permanent solution to your inverted nipples.
The surgery is basically cosmetic, apart from when you have a grade 3 inversion in which case it may be necessary to enable you to breastfeed.
Inverted nipples can be fixed using two different types of surgical procedures. One surgery preserves the milk ducts and other surgery does not preserve the milk ducts.
Before undergoing any of the surgery procedures, talk to your doctor about their advantages, disadvantages and risks. Each of the surgical options typically takes 1 to 2 hours, and you can return home a few hours after the surgical procedure.
The cost of nipple piercing ranges between $500 and $800 depending on the nipple inversion grade, type of surgery and the country or location. It may cost much less if you have an insurance policy and it is accepted in the clinic of your choice. The followings sections outline how to fix inverted nipples through surgery.
(a) Duct Dividing Surgery (Surgery with Detached Milk Ducts)
.This type of breast surgery does not preserve the milk duct system. Therefore, women who undergo this procedure won’t be able to breastfeed upon recovery and in the future. However, you will not have any problem with your nipple sensitivity after recovery. This procedure is the more common of the two types.
Procedure:
- Your doctor will clean the breast area and apply a local anesthesia topically, or by injection.
- Once the anesthesia becomes effective, the doctor will make an incision at the base of the nipple
- The doctor will lift the nipple from the breast, and detach the milk ducts to allow the nipple to protrude.
- The doctor will sew the nipple together with areola in a protruding position.
- Lastly, the doctor will close the incision area, clean the area with a swab and dress it with a medicated gauze.
The doctor will give you advice on the aftercare measures you need to take for fast healing and to avoid an infection in the surgery area.
(b) Duct Preserving Surgery (Surgery That Partially Preserves Milk Ducts)
This type of breast surgery also called the parachute flap technique. It preserves part of the milk duct system. Therefore, women undergo this procedure are still be able to breastfeed after recovery. Usually, you will not experience any change in nipple sensation after the procedure.
Procedure:
- Your doctor will clean the breast area and apply a local anesthesia topically, or by injection.
- Once the anesthesia becomes effective, the doctor will make an incision around your nipple base.
- The doctor will lift the nipple from the breast and sew it together with areola in a protruding position.
- Lastly, the doctor will close the incision area, clean the area with a swab and dress it with a medicated gauze.
The doctor will also give you advice on the aftercare measures you need to take for fast healing and to avoid an infection in the surgery area.
Before and after Inverted Nipple Treatment Pictures
Here are some pictures showing inverted breast before and after surgery
When to See Your Doctor over Inverted Nipples
Generally, having an inverted nipple naturally does not pose any threat to your health. In addition, it does not affect you the sensitivity of the nipple and breast. Hence you will have a normal sexual life. In summary, an inverted nipple should not be a cause for concern if
- It has been present since birth childhood or puberty
- It develops gradually over many years
- It occurs during pregnancy, breastfeeding, or surgery on the breast
However, if you develop inverted nipples for unclear reasons, especially when this happens suddenly, consult your doctor. Though very rare, developing inverted nipples later after birth or puberty may be a sign of breast cancer. Like any cancer, Breast cancer is more easily treated in its early stages.
Sources and References
- Inverted Nipples: http://www.embarrassingissues.co.uk/invertednipples.html
- Inverted Nipple: http://www.medicinenet.com/inverted_nipple/symptoms.htm
- How to Get Rid of Inverted Nipples: http://www.wikihow.com/Get-Rid-of-Inverted-Nipples
- How to Treat an Inverted Nipple: http://www.healthline.com/health/inverted-nipple-treatment#overview1
- Nipple inversion is common yet be a cause of great concern: http://www.stephenmcculley.co.uk/our-procedures/cosmetic-breast-surgery/inverted-nipples/
- Inverted Nipple Correction To Complete Your Breast Contour: https://www.myplasticsurgeon.ca/cosmetic-procedures/surgery/inverted-nipple-correction/
- Flat or Inverted Nipples: https://www.breastfeedingbasics.com/articles/flat-or-inverted-nipples
- Inverted Nipples – Causes and Treatment Options: https://www.ganchi.com/inverted-nipples-causes
- Inverted nipple: https://en.wikipedia.org/wiki/Inverted_nipple
- Inverted Nipple Correction – Malaysia – Before and After: http://makeovervacations.com/inverted-nipple-correction-malaysia-before-and-after/
- 5 Fast Facts About Inverted Nipple Revision: https://www.southernsurgicalarts.com/blog/fast-facts-about-inverted-nipple-revision
- Are Inverted Nipples Common? https://www.bustle.com/articles/62795-are-inverted-nipples-common-6-things-you-should-know-about-having-a-pair-of-innies
