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Inverted Nipples Causes, Grades, and How to Fix Nipple Inversion

Studies show that 24 percent of women have at least one inverted nipple. Some men have them too. The causes of innies are in most cases harmless. 

They are graded depending on how easy it is to protract them. For cosmetic and breastfeeding reasons most women opt for correction treatments such as surgery to get rid of such nipples.

There are also other non-surgical methods that have been used for ages to pull the nipples out, as you will found out as you read on.

What are inverted nipples?

inverted nipple

This is a nipple that is pulled inwards into the breast tissue instead of pointing outwards. What does an inverted nipple look like? Is it unusual to have such nipples? If a nipple is more indented than protruding, it is considered inverted.

However, some nipples are retracted for some time and will always pop out following stimulation or changes in temperature.

Are inverted nipples normal?

This type of nipples is normal, and in most cases need no cause for alarm. Are they common? Yes, these nipples are quite common, 20% of women have both of their nipples inverted.

You should never feel embarrassed if you have innies, studies show that 14% of men also have retracted nipples which make it normal.

Research has shown that a third of pregnant women will experience this type of nipples at some point in their pregnancy. For most women innies are not permanent they simply come and go.

But sudden nipple retraction accompanied with other symptoms such as pain and discharge might be a sign of a serious condition such as cancer. Sudden nipple retraction in adulthood in the absence of pregnancy, calls for an immediate medical examination.

What causes nipple inversion?

Pulling in of the nipple is quite common in both men and women. Here are the few causes of nipple retraction:

1. Congenital

In some cases, nipple retraction is an abnormality during early stages of fetal development in the uterus. The short ducts are in this case responsible for pulling in of the nipple. The nipple then stays pulled in ever since the breast developed.

2. Periductal mastitis

Periductal mastitis occurs when the breast duct beneath the nipple gets inflamed and tender pulling the nipple in. In most incidences, periductal mastitis is unrelated to breast cancer its primary cause is usually an infection.

However pus-like discharge should be a sign of underlying bigger problem. It is therefore advisable that you seek medical attention as soon as possible.

3. Duct ectasia

The breasts are made up of connective tissues that include milk ducts.Breast ectasia occurs when the milk ducts that carry milk to the nipple get blocked or swollen.

An inflamed nipple retracts because of the pulling pressure of the swollen ducts.

4. Cancer

Cancer is a malignant disease affecting both men and women of all ages. Breast cancer occurs in any part of the breast. Cancer occurs in the cells due to an acquired cell DNA mutation.

It causes scaling and thickening of the breast tissues behind the nipple hence pulling it in. Other symptoms of breast cancer include pain and breast tissue inflammation.

3 grades of retracted nipples

The retracted nipple grading depends on how easily they can be protracted and the degree of fibrosis around the individual breast together with the damage it has caused to the milk ducts.

Here are the 3 grades of inverted nipples:

1. Inverted nipple grade 1

This refers to the nipple that can easily be pulled out, by using a finger pressure around the areolar. Inverted nipple grade 1 maintains the projection after protraction.

It is also easy to breastfeed with inverted nipple grade 1 since milk ducts are not usually affected. Inverted nipple grade 1 has less fibrosis and normal lactiferous ducts.

Inverted nipple grade 2

Inverted nipple grade 2 means that the nipples can be easily be pulled out, though not as easy as inverted nipple grade 1.They have a moderate degree of fibrosis, and the lactiferous ducts are slightly retracted but do not need to be cut off for release of fibrosis.

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Breastfeeding might be possible with inverted nipple grade 2 if the only retraction does not occur after protraction.

  • Inverted nipple grade 2 is the most common nipple inversion type among most men and women with retracted nipples.

Inverted nipple grade3

Inverted nipple grade 3 describes nipples that are severely retracted which can rarely be pulled out. Protraction in inverted nipple grade 3 is only possible with surgical interventions.

Milk ducts are usually constricted making breastfeeding impossible. Lactiferous are short and fibrosis prominent in inverted nipple grade 3.The breast lacks enough soft tissue and needs surgery to get rid of the thickening around the areolar.

How to fix inverted nipples

In most cases, inverted nipple is a natural occurrence that does not pose a health risk. This type of nipples can occur on one or both breasts.

  • Retracted nipples in some women get back to normal after stimulation or changes in temperature. However, most women have permanent innies that require manipulation to protract.

Grade 1 and grade 2 types of inverted nipples can be easily fixed at home, however, grade 3 might need surgical intervention for continued protraction. Here’s how to get rid of retracted nipples:

1. Try Hoffman technique

This is an ancient method of drawing out retracted nipples. Follow the following steps to get rid of such nipples using Hoffman technique.

  1. Place your thumbs on either side of the nipple. Ensure that the nipples are placed at the base of the nipple, not outside the areolar.
  2. Press firmly into the breast tissue.
  3. Pull the thumbs away from each other while still pressing down.
  4. Move your thumbs all around the nipple and repeat severally in a day.

This method can be used every time you want your nipples to protrude; however, how long the effect lasts differs from woman to woman.

2. Use suction devices

Most suctioning devices are worn under clothing for some time to help reverse retracted nipples. The most common suctioning devices include:

  • Shells
  • Cups
  • Nipple protractors
  • Nipple extractors

These devices work by pulling the nipple into a small cup, therefore stimulating the nipple to protrude. When used for longer they help loosen the nipple tissue which in return makes the nipple stay erect for a longer period.

3. Get a piercing fix

Yes, you can have a piercing fix as a correction treatment for such nipples. The jewelry worn in the piercing can help keep your nipple erect state as much as possible.

Nipple piercing can be done in parlors but always make sure that your piercer is licensed and has experience piercing such type of nipples.

What to expect

During piercing fix, expect your piercer to use a cold cloth or nipple clamps to draw out the retracted nipples. Your nipples may feel itchy and sore because of the pressure of pulling them out.

The piercer uses a gauged needle to thread a piece of jewelry into the nipple. In most cases, the jewelry used is a stainless and less vulnerable to infections in the future.

The jewelry is then held in place with screw-balls in both ends to prevent the nipple from sinking back.

  • It is advisable to keep the ring in place for at least six months before switching it to allow proper healing of the nipple. Also taking the jewelry out for long may cause your nipples to get back to their earlier inverted nature.

Most importantly talk to your piercer and doctor about the benefits of piercing fix and the potential risks involved, before undergoing the procedure.

4. Use a breast pump

Breast pumps come in variety. It is always good to talk to your doctor to recommend a suitable one for your case. Here is how to get rid of retracted nipples with use of breast pumps:

  • Place the phalange over your breast; ensure that the nipple is centrally placed inside the hole. A correct phalange covers the nipple, so should yours.
  • Hold the phalange against your breast ensuring a seal against the skin
  • Holding the phalange in one hand, turn on the pump
  • Pump at the highest strength that you find comfortable.
  • Hold the two bottles in one hand and turn off the pump with the other hand.

If breastfeeding, give the nipple to the baby once erect

5. Use inverted syringe

Use of an inverted syringe is an ancient method that is still effective in pulling out inverted nipples. Syringes used in this method depend on your breast size.

  • Use a sharp scissors to cut the syringe at where it reads“0ML”(side opposite the plunger)
  • Reinsert your plunger at the end you just cut off, pushing it all the way in
  • Place the uncut end on your nipple and draw the plunger so that your nipple protracts
  • Do not pull further than it is comfortable
  • Do not remove the syringe from your breast before pulling back into the break function.
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Always wash the syringe with hot water and use every time before nursing or as preferred.

 Surgery to correct inverted nipples

Surgery to get rid of retracted nipples is usually done in the best interest to help restore the projectile state of the nipples. Retracted nipples correction treatment is suitable for both men and women.

The cost of the surgery depends on other procedures involved and type of medications prescribed afterward.

  • The correction treatment takes place under local anesthesia, for about an hour. The surgery to get rid of such nipples can be done on one breast or both to improve symmetry between the nipples.
  • Nipple correction treatment involves protracting the inverted nipple and supporting it with a loop. Also if one wishes to achieve a permanent result, an implant is placed under the nipple during the correction treatment.
  • Surgery is usually combined with breast lifts and augmentations to achieve beautiful young- looking breasts. The before and after photos of correction treatment always show normal protracted nipples.
    The treatment is easy and fast, meaning that healing takes place at home. You can always get fit to work after two days following intake of painkillers as prescribed by your doctor.

Inverted nipple piercing

Can you pierce inverted nipples? The breast tissue is very flexible as long as you have a pinchable area of skin, you can pierce retracted nipples. Both men and women with these nipples can get piercings as they desire after consulting with their doctor.

inverted nipples piercing

Nipple piercing can be an advantage for inverted nipples as it keeps skin firm preventing it from retracting. Nipple piercing, however, comes with its share of problems such as migration, pain, and infections.

Position of the piercing

The piercing is made in the crease, at the very base of the nipple where it rises from the areola. The piercing is done horizontally.

Jewelry for piercing

It is important that you choose high-quality jewelry before the actual piercing. A high-quality biocompatible jewelry will certainly facilitate faster healing.

Always go for longer jewelry because they prevent constriction after tissue swellings. The initial jewelry should be in place for about eight weeks to allow proper tissue healing.

Healing process

Complete healing time for a nipple piercing can be quite a long. A full healing period is six months to a full year. A proper wound care and proper jewelry placement can help reduce the wound healing time. Proper wound care simply means that even your hands have got to be clean before touching the nipples to avoid contamination.

Caring for the pierced nipples

Your doctor or piercer will give you a proper advice on how to care for your wound. In most cases, the information given is tailored specifically to the placements of the new piercing.

Poor hygiene leads to complications such as rejection, irritations, and infections. In the case of such complications, you are advised to contact your piercer or doctor immediately.

 Inverted nipple and breast cancer

Is nipple retraction a sign of breast cancer? An inverted nipple might be or not be a sign of breast cancer. Nipple inversion can be due to tissue scarring behind a nipple or a result of a malignant condition such as cancer.

In the case of cancer expect symptoms such as breast lumps, swellings, skin irritations, nipple pain discharges, scaliness and thickening of the breast skin.

  • Nipple retraction in cancer occurs when the tumor attacks the duct behind the nipple pulling it in. In such a case imaging examinations such as x-ray and breast ultrasound are done to confirm the presence of a cancerous tumor in the breast.

Flat nipples vs. inverted nipples

Flat nipples are often confused with retracted nipples but what is the difference? The only way to know if your breasts are flat or retracted is to do a pinch test.

  • A pinch test is simply done by gently squeezing the areolar one inch behind the breast by use of the thumb and index finger. This technique will make flat nipples remain flat (without any protraction or erection) while retracted nipples pull inwards.

Another difference between flat nipples and retracted nipples is that flat nipples are easier to retract as compared to inverted nipples whose protraction depends on the degree of inversion.

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How to breastfeed with inverted nipples

Women breasts come in variety of sizes. Your nipples are said to be flat when they don’t protrude much beyond the areolar.  In most cases, flat nipples protrude a bit more during pregnancy making it easier to breastfeed.

However this type of nipples tends to squeeze inwards when pinched, however, this does not mean that baby feeding won’t happen. For a successful breastfeeding, you simply need to learn some few techniques.

Early stages of breastfeeding are difficult to get by, a woman’s determination is simply what gets her breastfeeding the baby every single day.

Here are five ways in which you can try to make breastfeeding a little easier especially when working with retracted nipples:

1. Proper positioning

For the baby to properly take the breast into the mouth and feed properly, he or she must be properly positioned. This way the baby can stimulate milk production and adequate functioning of the glands supplying the milk.

A proper position ensures that you and your baby are comfortable during the whole breastfeeding process. Here are four steps to breastfeeding properly:

  1. Start by sitting upright and nuzzling the baby’s tummy into yours.
  2. Let the baby’s head rest in the sideways position away from yours.
  3. Always signal the baby to open the mouth by placing the nipple into the baby’s lower lip.
  4. Place the breast into the baby’s mouth once it’s wide open. Always try this process until the baby’s tongue is positioned under the nipple.

Proper positioning might be a little trickier especially for new mothers for new mothers. Daily learning makes a great difference in the long run.

2. Use Breast Shields

Breast shields are commonly known as breast cups. They are simply ring-shaped; they help draw out your nipple when placed inside the bra.

Nipples naturally protrude after seven months of pregnancy in preparation for breastfeeding. Breast cups are vital when the nipples remain flat or inverted even after seven months of gestation.

Shields can be worn two months earlier before the baby is born. However one should be careful not to let moisture get trapped between the cup and the breast skin.

Breast cups can be worn at night to avoid moisture trapping which can lead to other problems. It is always advisable to use them earlier every time before nursing your baby.

3. Try Nipple massage

There are several techniques of nipple massage that one can use to pop out retracted nipples. One best way is to press down the sides of the areolar until the nipple projects.

Additionally, you can grab the nipple gently and pull it in an up-down out motion for at least five times a day to help loosen and stretch the nipple tissue.

4. Try Nipple stimulation

Another way to fix such nipples is by stimulation. Nipple stimulation is usually done after birth whereby the mother holds the nipple firm between her thumb and the index finger and rolls it severally. Stimulation is only possible when a cold cloth or ice cube is used on the breast.

5. Use Breast pumps

Breast pumps have increasingly become a nursing mother’s best friend. Not only do breast pumps help suction milk, they also help erect the nipples for breastfeeding.

Breast pumps can be used before the birth of the baby to expand breast tissue as a preparation for later breastfeeding.

  • The pump is also useful in cases where the nipples are experiencing difficulties to come out even after the birth of the baby.

Remember

Inverted nipples are common among men and women. There are many ways of protracting such nipples, even though it is always best to talk to your doctor before any nipple manipulations.

You might need a proper examination to determine the cause of nipple inversion before any correction treatment procedures.

  • Breastfeeding with retracted nipples is possible; you only need to talk to your doctor to determine a proper method of nipple protraction for you.
  • Breastfeeding itself depends on other several factors; ultimately it is never advisable to feed the baby on one breast that might be erect. The baby’s nutritional demand increases with age, thus you are advised to breastfeed on both breasts.
  • Breastfeeding with this type of nipples needs patience and continued practice.
  • Nursing often enables your baby to have the best of nutrients only found in breast milk.

SOURCES AND REFERENCES

  1. Mammary duct ectasia (May 2015)

http://www.mayoclinic.org/diseases-conditions/mammary-duct-ectasia/basics/causes/con-20025073

  1. Breast cancer (March 2014)

https://my.clevelandclinic.org/health/articles/breast-cancer-an-overview

  1. Nipple discharge (July 2015)

http://www.nhs.uk/conditions/nipple-discharge/Pages/Introduction.aspx

  1. What are symptoms of breast cancer? (March 2016)

https://www.cdc.gov/cancer/breast/basic_info/symptoms.htm

  1. Breast Augmentation (May 2014)

https://my.clevelandclinic.org/cosmetic-plastic-surgery/procedures/breast-augmentation?cvosrc=ppc.bing.breast%20augmentation%20surgery&matchtype=b&cvo_crid=0&cvo_ca mpaign=CS%20-%20Plastics%20-%20DR%20-%20Breast%20Surgery#expect-tab

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