Inverted Nipples

When a woman looks below her chin she is aware of her own special and unique body—and nipples are part of that uniqueness. Indeed nipples vary in shape and size from flat, to pointed, to having one or 2 “lobes” at the tip, to bumpy, to looking like a dimple, or to being a total “innie”. And all variations are perfectly normal. Most nipples do stick out a bit, from 5-10 mm. But for both women and men having one or both nipples not prominent can be the cause of personal self-consciousness, and with woman, concerns with regard to potential breastfeeding.

What Causes Inverted Nipples?

Flat or inverted nipples are actually pretty common. About 10-20 percent of all women are born with them. Inverted nipples from birth are not medically harmful. There are actually 2 types of inverted nipples. Many health professionals may refer to “shy” nipples. A shy nipple can be pulled inwards, but at other times protrude. A “shy” nipple can point out in cold temperatures such as cold water, or can be brought out with some massage or stimulation.

True inverted nipples are present from birth, and do not protrude with cold or stimulation. The cause is usually from connections in underlying tissue, ligaments and the skin. Ligaments along the milk ducts, which connect to the nipples, are shorter and pull the nipple in towards the breast tissue.

If nipples seem inverted later in life, or after breastfeeding, the cause can be that the skin of the breast can become looser and relax around the nipples making the nipples to appear to be inverted. However, if a nipple has not always been inverted and suddenly does so, it is important to see your doctor right away to determine if there is some other medical cause.

Are Inverted Nipples A Concern for Breastfeeding?

Research indicates that about 28 to 35 percent of women, who are pregnant for the first time, have nipples that don’t protrude that well. And 10% are considered inverted nipples. That is quite common indeed. However, inverted nipples should not interfere with sexual enjoyment and may not even be a problem with breastfeeding. Many women with inverted nipples may find that during their pregnancy, or during breastfeeding, their nipples come out either temporarily or sometimes permanently. With proper breastfeeding technique an infant can latch onto the areola—around the nipple-- so women with inverted nipples can breastfeed without necessarily any difficulty. Additionally, an infant who latches on well may actually be able to draw out an inverted nipple.

The use of suction devices such as a breast pump right before feeding may help to bring out an inverted nipple. Health professionals do recommend that you take special precautions to keep your breasts and nipples clean, as you can be prone to infection if there is discharge and the nipples are inside folds of skin.

If you are planning a pregnancy or at the beginning of one, it is important to get your breasts checked by your doctor to discuss any of your concerns with breastfeeding.

Aids to Inverted Nipples

If you are unsure whether or not you have a true inverted nipple or nipples, there are some simple home practices that have been effective for many women.

• You might try to coax the nipple out with ice or stimulation.
• Another method some women have found helpful is by gentle rolling the nipple.

Devices and Surgery

There are choices of devices available for aiding a shy or inverted nipple to protrude. Some women have found these devices helpful, others not at all. The determination of the effectiveness of these devices in making a cosmetic change is individual. Devices include the niplette, nipple rings, a nipple protractor constructed from a disposable syringe, and the Hoffman technique, a nipple stretching technique.

There is product known as Breast shells found in maternity shops or online that have been found to be helpful by some women. They are a small plastic discs with a hole in the center, which allows the nipple to protrude. A dome to allow air to circulate covers the disc. The shell exerts some pressure, which can encourage the nipple to stand out. They are worn inside the bra.

Surgery is usually only chosen after a family is completed and/or when breastfeeding is no longer considered. There are several different procedures that can be used. However, these options should be explored and discussed with your doctor to determine your goals and outcomes. The operation can be performed under local anesthetic. Some surgeries are promoted as simple procedures that do not effect breast-feeding potential. However other surgery procedures divides the breast ducts beneath the nipple, or cuts the milk duct, which can affect breast-feeding.