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Inverted Nipples Causes and Correction (Nipple Retraction)

July 10, 2018

Why are my nipples inverted? Is it an indication that something is wrong with them or is it just normal? Let us discuss this issue of inverted or retracted nipple including causes and treatments to reverse the retraction.

What is a retracted nipple?

This refers to nipples that retract inwards into your breast instead of pointing outwards. They can be permanent or temporary depending on their cause.

The retraction or dimpling can be of different grades from slight to complete retraction i.e., according to babycenter.com may “look flat, or their appearance may range from slightly dimpled and indented to very clearly indented in the center.”

The easiest way to confirm if they are indented or not is “gently squeezing the areola about one inch behind the nipple with your thumb and index finger. If it becomes dimpled or clearly indented, it’s inverted,” notes babycenter.com

The inversion can be natural or due to an underlying health condition. Some women, especially young women will find it as aesthetically unappealing. Note that some inverted nipples reverse themselves when stimulated or when the weather changes.

However, some serious causes, especially those present at birth can be permanent or be resolved through surgical procedures.

Therefore, this problem can be congenital or be acquired. It can occur in one or both breasts. Furthermore, this condition can affect both men and women. However, is commonly bother when it affects women.

What causes the inversion?

The basic reason why the nipples become inverted is when the inward pull by milk ducts is more than muscle found inside of your nipple that pushes it outwards. Many things can cause it.

Temporary causes

There are cases of temporary nipple retraction that occurs naturally due to changes in the environment. For example, can occur when there are temperature changes and would resolve after normalcy. They are normal and do not pose a health risk.

Inversion present from birth

Some women are usually born with flat or inverted nipples. The same condition can also affect a few men. Dermatologists argue that when present at birth are usually harmless and not a symptom of a potential health condition.

The retraction at birth can affect one breast or both and this occurrence can be linked to genetics and can trend in certain families due to inherited genetics.

Breast cancer dimpling

If your nipple is inverted or dimpled all over sudden, then you need to immediately seek the attention of your medical service provider. If it retracts suddenly, this is among the symptoms of inflammatory breast cancer (IBC).

Other symptoms include lump or breast, discharge from the nipple, and changes in its skin color or of the area around breast and areola. Breast cancer dimpling usually affects one breast, if you have dimpling on that this is likely not to be cancer.

Before this cancer develops a dimpled nipple, early symptoms include itching or inflammation accompanied by minor bumps. IBC is common in women under the age of 60 and above. This is a serious medical condition that needs early immediate medical attention.

Infections and inflammation

This is another common cause. Frequent infections or inflammations of the breast tissue may over time lead to scarring which would then result in the indented nipples. This can be due to poor hygiene, originate from elsewhere on the body, among other causes.

Inverted nipple after pregnancy

According to ganchi.com, “pregnancy and breastfeeding can take their toll on a woman’s breasts. Breasts can become saggy or droopy with expanded areolas and in some cases, one or both nipples may invert.”

During pregnancy and breastfeeding period, there are also hormonal changes that would trigger acne breakouts that would leave behind scars after healing, this too can lead to this problem.

Fat necrosis (non-cancerous breast lumps)

This is benign that is not related to cancer. It is usually painless but in certain circumstances, your breast can be tender. The skin around nipples can appear dimpled, bruised, or red in color. This condition can occur due to injury to the breast or previous radiotherapy and surgery.

Can retraction pose a challenge in breastfeeding?

This does not interfere with sexual pleasure or breastfeeding. There are cases where even the retracted ones right from the birth would tend to come out temporary or permanently during pregnancy or breastfeeding. Again, good latches from infants would draw them out.

However, they can be disconcerting and even lead to problems during breastfeeding as well. Here, we are referring to a severe case. Serious causes of the dimpling such as IBC can block a mammary gland and thus a woman with an inverted nipple would not breastfeed.

Treatment options

Inverted nipples can be corrected according to the grades of inversion. The severity ranges from grade 1, grade 2, and grade 3. Grade one inversion is mild a case in which the condition can reverse of its own. Grade two inversion is moderate and grade three inversion is very serious that may only be corrected through surgical procedures.

There are several options that can be considered for reversing indented nipples, some of which are temporary while others are permanent. The effectiveness of various treatments would depend on the severity.

Temporary options for inverted nipples

Here are temporary fixes:

Hoffman technique

Some cases under grade one inversion can be reversed manually. The best manual option is the Hoffman technique. You can perform the Hoffman technique by placing both of your thumbs at the base of your nipple and using a gentle motion to pull your thumbs away from each other.

This method should be repeated several and is always done to prepare for breastfeeding. You can begin doing it in later stages of pregnancy.

Nipple stimulation

They can also be made to protrude before breastfeeding by being stimulated. This involves grabbing it with a thumb and a finger and twisting it in a rolling motion for about 30 seconds. To further help the stimulation, you can apply the cold, wet cloth on it.

Use suction devices

Nipple suction devices would also provide temporary solutions to retraction. They would also offer a permanent solution in cases of mild inversions. A number of suction devices are available in the market and thus, you should talk to your doctor before you acquire one.

Nipple piercing

You can also pierce it and hold it in place using a piercing barbell for almost three months. This would stretch the ducts and probably reverse the inversion. Only a few cases of re-inversion after piercing have been reported.

Unfortunately, not all patients are comfortable with piercing but are rest assured that piercing doesn’t destroy the ducts or nerves.

Use clamps

You can as well use clamps to hold the nipples in an erection position. This would stretch the tissue and make it remains erected for some period.

Permanent solutions

The best and the only known permanent solution is nipple correction surgery. This method preserves the milk ducts while concentrating on releasing the surrounding fibers that are holding it in an inverted position. The fibers are disengaged and stretched to make the nipples protrude.

There are devices that would be placed on the nipples after surgery to make sure they don’t retract. However, this would make the wearing of the usual bras or clothing very difficult.

Treat the underlying causes of the dimpled nipple

As you may have noticed, the dimpling would be a symptom of an underlying condition. In many cases, correcting the nipple without treating the underlying condition may not be helpful. Inversion due to infections, inflammation, or cancer, by treating the causative agents.

The named conditions have various symptoms apart from the nipple inversion. We now advise that you see you, doctor, if you have the following conditions accompanying you’re the retraction:

  • Suddenly inversion
  • A hard and painful lump in the breast or hard mass in the breast
  • A large lump in the breast
  • Persistent itchy spot on breast
  • Any other symptom on the breast that you suspect could signify a more serious condition.