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How do you tell if your nipples are inverted?
If you’re not sure whether your nipple is inverted, try the ‘pinch test’: compress your breast gently, with your thumb and forefinger either side of the areola. Most nipples will poke out, but if yours retracts or pulls inwards, creating a hollow at the end, then it’s inverted.
What cancers cause inverted nipples?
Nipple retraction or inversion that is new, occurring only in one breast, or where the nipple does not come out on stimulation can be a concerning sign of breast cancer. This should be discussed immediately with your doctor.
How can I make my flat nipples stick out?
Breast shells: You may need to wear breast shells between feedings. 2 Breast shells put pressure on the base of your nipple to help it stick out more. Remove the breast shells before you breastfeed your child. Unlike nipple shields, you cannot wear breast shells while you’re nursing.
Dr Chantel Thornton > Symptoms & Conditions > Nipple Changes
Very good/Emily Roberts
What are flat nipples?
Flat nipples are not raised. They appear to be level with the areola and surrounding skin of the breast. Flat nipples don’t protrude from the breast, but they don’t turn inward either (these are called inverted nipples).
Real flat nipples
Many women have nipples that appear flat most of the time, but then lift up when exposed to cold temperatures or sexual stimulation. These aren’t really flat nipples. Real flat nipples do not respond to cold or arousal. But even if your nipples stay flat all the time, they will often protrude outwards during pregnancy.
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Even if you have protruding nipples. You can get flat nipples when your breasts swell. When your breasts are overflowing with breast milk, they can become hard and swollen. This can cause your nipples to become flat, making it difficult for your baby to latch on.
Breastfeeding with flat nipples
In general, flat nipples don’t usually interfere with breastfeeding. Most newborns can latch on to flat nipples with no problem. And as long as your baby can latch onto your breast properly, he’ll be able to pull out your nipples. You can also try these strategies if you or your baby are struggling.
Breast cups: You may need to wear breast cups between meals. Breast cups put pressure on the base of your nipple to make it protrude more. Remove the breast shells before breastfeeding your child. Unlike nipple shields, you cannot wear nipple shields while breastfeeding. Breast Pump: Try using a breast pump right before feeding your baby. Sucking a breast pump can help pull out and lengthen your nipples. There is also something called a nipple deflector that can help pull out flat nipples; discuss this with a lactation consultant. Breast engorgement relief: If your nipples are flat due to engorgement, try removing a little breast milk before breastfeeding your baby. Manually pumping or pumping breast milk before feeding helps soften swollen breasts and make it easier for your baby to latch on. However, you should only express a small amount of breast milk. If you remove too much breast milk, your body will produce more and engorgement can worsen. Nursing Holds: Use a V or C hold to gently squeeze your breast and expose your nipple and areola to your baby. These handles compress the breast like a sandwich so baby has something to hold on to. Learning how to hold and offer your breast to your baby can help encourage good latching.
If you are having trouble getting your baby to latch, or if you are unsure if your baby is latching correctly, have your baby’s latching position checked by your doctor or breastfeeding specialist. A trusted healthcare professional with breastfeeding experience can advise you on how best to manage your particular circumstances.
To make sure your baby is breastfeeding well from your flat nipples, look out for signs that she’s getting enough breast milk. Keep an eye on your baby’s wet diapers and be sure to take your baby with you to any scheduled doctor visits for weight control.
A word from Verywell
If you have concerns about your nipples or are having trouble latching your baby to your breast, seek help as soon as possible. A lactation consultant, your doctor, your baby’s doctor, or a local breastfeeding group can help you.
Will my inverted nipples ever pop out?
Grade I inverted nipples can “pop out” when exposed to cold or during arousal, or be manually popped out. Grade II nipples can be pulled out, but not as easily as grade I, and the nipple retracts quickly. Grade III nipples are severely inverted and it is very difficult to pull them out manually.
Dr Chantel Thornton > Symptoms & Conditions > Nipple Changes
What are Inverted Nipples? Need for cosmetic surgery – Dr. Nanda Rajaneesh | Doctors’ Circle
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Gallery Inverted Nipples Before and After Pictures, Images …
Free Digital Consultations Via Veo Conferencing. Browse before and after photos, and pictures of Inverted Nipples surgery performed by Dr. Dav Broadway.
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Inverted Nipples Before and After Photo Gallery
See before and after Inverted Nipples pictures of people who trusted Rockmore Plastic Surgery in Albany & Latham, New York, for their treatment.
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Inverted nipple: Treatment, causes, and pictures
Inverted nipples are relatively common in both males and females, and nipple inversion is not a cause for concern. Though no treatment is usually necessary, …
Source: www.medicalnewstoday.com
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Image: Retracted Nipple – MSD Manual Professional Edition
This photo shows a close-up of a retracted or inverted nipple of the breast in an adult female patient. This condition may be a clue to breast cancer, …
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Date Published: 11/18/2021
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Inverted Nipples Before and After Correction Photos
The after pictures have been taken immediately after the minor surgical procedure performed by plastic surgeon Adrian Richards under local …
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Inverted Nipple Correction Before & After Gallery
Click here to view the Inverted Nipple before and after gallery for Mark D. Epstein, MD. Our practice serves Stony Brook, NY and surrounding areas.
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Gallery Inverted Nipples Before and After Pictures, Images and Photos
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Breastfeeding with flat, inverted or pierced nipples
Breastfeeding with flat, hollow or pierced nipples Nipple shapes and sizes can vary greatly from woman to woman. Read our handy tips to make breastfeeding that little bit easier – no matter what type of nipples you have. Share this content
Most women’s nipples protrude and become more erect when stimulated by touch or sensation, but some have nipples that are flat or inverted. And some women have had one or both nipples pierced. Many moms with inverted, flat, or pierced nipples breastfeed without problems, but others need extra support. “Don’t panic if you have flat or inverted nipples, it’s often possible to breastfeed without any problems,” assures Sioned Hilton, a lactation consultant, neonatal nurse and health visitor who has been working with Medela in the UK for more than a decade. “Remember, when your baby is feeding effectively, your baby will be clinging to a bite of the breast, not just the nipple itself.” But during the first few days, when your baby’s mouth is still small and his sucking is less efficient, you can Inverted or flat nipples make it difficult for him to start sucking – especially if it’s too early or uncomfortable. “If your nipple is flat or inverted, it may not reach your baby’s palate to stimulate their palate and trigger their sucking reflex,” explains Sioned. “This could mean she’s having trouble latching or not being able to stay buckled for effective milk transfer.”
How to tell if you have flat or inverted nipples Flat nipples1 don’t protrude very far from the areola (the darker area around them) even when stimulated. An inverted nipple is indented in the middle. It can appear like this all the time or only when stimulated. Sometimes the inverted nipples retract so they are level with the areola, or they may even sink into the breast tissue. One or both nipples can be affected, and it is estimated that up to 10% of primiparous women have at least one inverted nipple.2 If you are unsure if your nipple is inverted, try the “pinch test”: squeeze your breast gently with your thumb and forefinger on either side of the areola. Most nipples stick out, but if yours recedes or pulls in and ends up with a hollow, then it’s the other way around.
Preparing Plunging or Flat Nipples During Pregnancy You may find that your nipples naturally become more prominent as your breasts change during pregnancy. If not, and you’re concerned that their shape might make it difficult to breastfeed, you can wear nipple formers. These soft, flexible silicone discs fit discreetly inside your bra and apply gentle pressure to your nipples to pull them out. “Nipple shapers can be worn from the 32nd week of a normal pregnancy,” advises Sioned. “Start with just one hour a day and work your way up to about eight hours. If you have an incompetent (weakened) cervix or are otherwise at risk of preterm birth, talk to a doctor about the best time to start use, as nipple stimulation can cause contractions. “You can continue to wear the nipple formers after your baby is born,” she adds. “Try tucking them in your bra 30 to 60 minutes before breastfeeding.” “I have inverted nipples and was about to switch to formula after two or three weeks of trying to get my baby to latch “, remembers Nina, mother of a child from Germany. “I sought help from La Leche League and a lovely lady came to see me and encouraged me to keep going. She suggested nipple formers which really helped. Somehow my little boy started to understand what to do! Breastfeeding was great then and we continued until he was 21 months old.”
Help your baby latch on to flat or inverted nipples If your baby likes to suckle on your finger but seems less interested in your breast, it’s a sign that your nipple may not reach her palate when it latches. She may become frustrated and withdraw and cry or even fall asleep on your chest. In this case, ask a lactation consultant or breastfeeding specialist to check your latch. There are several techniques you can use just before breastfeeding to reshape your nipples into a simpler shape that’s easier for your baby to latch on to. Sioned suggests: Roll your nipple between your thumb and forefinger so it sticks out
Pinch your breast just behind your areola with your fingers in a “V” or “C” shape to push your nipple outward
Briefly touch your nipple with a cold compress or ice cube to erect it
Pumping by hand or using a breast pump for a few minutes before breastfeeding to pull the nipple out further “I have a flat nipple, but didn’t find out until Austin was having trouble breastfeeding on that side,” says Jennifer, mom of two children from Great Britain . “There’s nothing wrong anatomically – it just doesn’t spring open like that, which makes locking a little trickier. Before feeding on this side, I would always pinch and squeeze it a little and put it in his mouth. It was a bit tricky at first, but over time it got a lot easier.”
Using a Nipple Shield to Help Baby Latch If none of the above helps and your baby is still having trouble sustaining latching, your lactation consultant or lactation specialist may advise you to feed your baby through a nipple shield. This is a thin, flexible piece of silicone shaped like a nipple with holes in the tip for your milk to flow through. The nipple shield provides your baby with a larger, firmer target and stimulates their palate to encourage sucking. In general, nipple shields should be considered as a short-term solution. If problems or pain arise, consult your lactation consultant or breastfeeding specialist who will ensure your baby is well latched with the shield on. You’ll also need to monitor your baby’s weight gain to make sure your milk supply builds up to meet his or her needs.3 Over time, as your baby’s sucking becomes stronger and your nipples become more accustomed to breastfeeding, you can possibly also without a nursing nipple shield. “My nipples are pretty flat. A healthcare professional recommended nipple shields to my two babies and I have used them with great success,” says Anne-Sophie, a mother of two from Sweden. “My secret to making them stick to the skin is to slightly dampen the edge before use.”
Breastfeeding with pierced nipples Many women with pierced nipples find that it doesn’t affect their ability to breastfeed – although you must remove the jewelry before breastfeeding as it poses a choking hazard and can damage your baby’s tongue, gums or palate could. “I had a nipple piercing but removed it a year later when I got pregnant because my breasts were tender,” says Kellie, mother of three from the UK. “I exclusively breastfed my daughter and then her two younger brothers with no problems at all. If anything, the pierced nipple was the favorite!” Other mothers find that breast milk leaks from their piercing holes, or suspect that scarring from the piercing reduces their milk production4 – although there is limited research in this area. “It’s impossible to know how a piercing will affect breastfeeding until your milk arrives,” says Sioned. “Get advice from a lactation consultant or breastfeeding specialist if you are concerned. And remember, babies can get all the nutrition they need from just one breast if there is a problem with the other.”
If you can’t breastfeed with flat or inverted nipples If you’ve tried everything and breastfeeding just isn’t working, you still need to feed your baby. “The most important thing is that mom and baby are doing well,” says Sioned. “Exclusive pumping so your baby has expressed milk at every feed might work for you. Or you could try an additional breastfeeding system so your baby can practice breastfeeding at your breast while being pumped milk through a tube. This means she’s still having the breastfeeding experience and will stimulate your milk production, which in turn can help you express more milk.” “I have inverted nipples. After a disastrous breastfeeding experience with my first son, I was determined to be successful with my second,” says Babettli, mother of two from Italy. “I’ve taken expert advice and tried nipple formers and nipple shields, but to no avail. In the end, pumping exclusively with a Medela Symphony double electric breast pump, suitable for hospital use, was the best option for us. I pumped every feed for four months.”
Caring for different types of nipples You may need to take extra care of your flat or inverted nipples as your baby may suck on them more, which could make them sore at first. For tips on how to combat sore nipples, see Nipple Care for Nursing Moms. If your nipples retract after feeding, any moisture can make them sore and increase the risk of infections, including thrush. After feeding, pat them dry before they have a chance to sink back. Flat and indented nipples can be more difficult to manage when your breasts are swollen — when even normally erect nipples can become temporarily flat. Read our article on breast swelling for advice. The good news is that repeated feedings or pumping can change your nipple shape, so breastfeeding may become easier as your baby grows. And you may not have any problems at all if you have another baby – as Leanne, mum of two from the UK, discovered: “Breastfeeding the second time was a dream,” she says. “Nearly four months of pumping for my first son helped stretch my flat nipples and my second son latched on immediately without a nipple shield. Now at nine months he is still drinking.”
References References 1 Pluchinotta AM. The chest clinic. Springer International Publishing; 2015. 2 Alexander JM, Campbell MJ. Prevalence of inverted and non-protractile nipples in prenatal women who wish to breastfeed. The breast. 1997;6(2):72-78. 3 McKechnie AC, Eglash A. Nipple shields: a review of the literature. lactation medicine. 2010;5(6):309-314. 4 Garbin CP, Deacon JP, Rowan MK, Hartmann PE, Geddes DT. Association of nipple piercing with abnormal milk production and breastfeeding. JAMA, Journal of the American Medical Association. 2009;301(24):2550-2551.
Dr Chantel Thornton > Symptoms & Conditions > Nipple Changes
Changes in the nipple can be an important sign of breast cancer, and any new change should be evaluated by a doctor right away.
Nipple retraction and inversion
Humans can be born with inverted nipples, in which the nipples are depressed inward, although they generally point outward when stimulated. This is completely normal and does not need to be evaluated by a doctor.
Nipple retraction or inversion that is new, occurs in only one breast, or where the nipple does not come out when stimulated can be a worrying sign of breast cancer. This should be discussed with your doctor immediately.
Skin changes of the nipple
The skin of the nipple may become red and scaly, crusty, or thickened. These can be important signs of a type of breast cancer, particularly Paget’s disease.
Paget’s disease of the nipple
Paget’s disease of the nipple is a very rare form of breast cancer, accounting for approximately 1-2% of all newly diagnosed breast cancers. It presents as a scaly, raw, or ulcerated lesion on the nipple and may spread to the areola. A bloody discharge may be present, although it can often be clear or yellow.
Nipple pain, burning, and itching can occur months before the typical ulcerated lesion appears.
A palpable lump can be felt in about 50% of cases, which is typically behind or near the nipple and areola, but it can be anywhere in the breast.
nipple discharge
Spontaneous nipple discharge is the third most common reason women see a breast surgeon. Nipple discharge can be physiological or pathological. It can be associated with benign or malignant pathology. It can cause significant anxiety; Fortunately, however, it is the main symptom of breast cancer in less than 12% of all cases.
The discharge of most concern is spontaneous unilateral sustained discharge. The consistency and color of the discharge does not reduce the suspicion of breast cancer.
Discharge from breast cancer can be clear, sero-bloody, or blood-stained.
About half of patients with nipple discharge will also have a breast lump, and 20% of these patients have breast cancer.
With regard to nipple discharge, the following questions must be answered:
Is there spontaneous nipple discharge (fluid coming out of the nipple without nipple compression or pressure on the breasts)? This is often best appreciated when discharge is seen on the bra or clothing. Or does discharge only occur when expressing (fluid is only expelled from the nipple when the nipple is squeezed or stimulated or pressure is applied to the breast)?
It is also important to determine if the nipple discharge is unilateral or bilateral (one breast or both breasts)?
Is it coming from one channel or multiple channels?
What color is the nipple discharge?
Nipple discharge is common and occurs in up to 70% of healthy women when the breast is massaged or devices such as a breast pump are applied. By stimulating the nipple, fluid discharge can also be achieved in women who are not breastfeeding (physiological discharge). It’s not spontaneous. It’s nothing to worry about.
Milky nipple discharge is commonly seen in the normal stages of pregnancy and breastfeeding. Imaging of the breast is usually done when examining nipple discharge, but nonspontaneous discharge from multiple ducts does not usually require surgery. Spontaneous nipple discharge unrelated to pregnancy or breastfeeding is considered abnormal. Spontaneous nipple discharge confirmed into a unilateral milk duct is more likely to be associated with an underlying pathology such as cancer or DCIS.
Nipple discharge associated with nipple nodule and areolar inversion/retraction of the nipple, even if not spontaneous or bloodstained, requires urgent investigation.
Causes of nipple discharge
Duct Ectasia – This is a common problem where the milk ducts under the nipples become enlarged and inflamed. It’s more common in smokers and more common after menopause. Discharge from duct ectasia is usually green, yellow, or brown on both sides and usually occurs for more than 1 duct. Surgical treatment is not usually required unless it becomes problematic for the patient and would usually take the form of complete removal of the duct.
Intraductal papilloma – is a small growth (wart-like lesion) in the milk duct, usually within 2 cm of the nipple. It can be asymptomatic or associated with nipple discharge. It usually comes from a single gait and is usually unilateral. In less than 10% of cases, a papilloma can be associated with cancer and surgical removal is required. It can occasionally be felt as a small lump near or just next to or under the nipple.
Types of intraductal papilloma
Single intraductal papillomas: 1 nodule, usually near the nipple, causing nipple discharge.
Multiple papillomas – groups of nodules do not usually cause nipple discharge and are usually not felt and are usually more than 2 cm from the nipple.
Papillomatosis, these are very small clusters of cells in the ducts, a type of hyperplasia (too many cells in the ducts scattered throughout the breast).
Intraductal papilloma can be removed with the procedure of microdochectomy. A small incision is made at the edge of the areola after a probe is inserted into a drainage canal while the patient is under general anesthesia. If a single intraductal papilloma is diagnosed at the operation. This does not increase the patient’s risk of breast cancer unless atypical cells are found in the pathological specimen; however, multiple papillomas or papillomatosis can slightly increase the risk of developing breast cancer.
Dermatitis or eczema – can affect the skin of the nipple. This can cause oozing and crusting over the nipple with nipple discharge. Cortisone-based cream is the first line of treatment. However, it is important that the problem is properly investigated (with a core biopsy of the affected skin) if trying a cortisone cream does not solve the problem to rule out Paget’s disease.
Paget’s disease of the breast – is a rare disease of the breast characterized by ulceration, erosion and crusting of the skin overlying the nipple and may be accompanied by nipple discharge. It is important that skin changes over the nipple are evaluated by a breast surgeon
Breast Cancer – About 5% of women with breast cancer have nipple discharge and some of them also have other symptoms such as a retracted nipple or a lump in the breast.
Galactorrhea – a milky, usually bilateral, nipple discharge unrelated to pregnancy or breastfeeding. It can occur in men and babies. It occurs when the pituitary or thyroid gland causes the abnormal production of prolactin. Prolactin is a hormone that stimulates milk production.
Some drugs can also cause galactorrhea, such as antidepressants, antipsychotics, drugs used to treat high blood pressure, cocaine, opioids, herbal supplements, the oral contraceptive pill, and hormone replacement therapy. Pituitary tumors, hypothyroidism (underactive thyroid), chronic kidney disease, and overstimulation of the nipples can also cause galactorrhea.
Nipple discharge management
dr Thornton will evaluate the nipple discharge by performing an examination and a breast imaging review (mammography and ultrasound) and occasionally a nipple swab. The nipple discharge is sent to the pathologist for examination under the microscope. Unfortunately, nipple secretion cytology has low sensitivity for detecting breast cancer and does not usually change the management of patients with a single spontaneous ductal discharge.
Microdochectomy (single duct excision) is the only procedure that will confirm a definitive histological diagnosis in a patient with single duct discharge.
Multi-ductal discharge, particularly when it is not spontaneous (eg, stimulation of the chest may produce physiologic discharge), is usually bilateral and surgery is not usually required. It is part of the normal functioning of the breast and is not caused by a problem. Physiological discharge does not require treatment. The patient is advised to resist stimulation of the nipples and breasts as the problem will perpetuate itself if the stimulation is applied continuously. The discharge usually stops when the patient stops pumping from the nipple.
Spontaneous solitary duct or bloody discharge requires full imaging of the breast in the form of ultrasound and mammography (for patients over 35 years of age). A sample of nipple discharge may be sent to the pathologist for cytological evaluation, and any mass or bump under the nipple or areola may be biopsied (fine-needle aspiration or core biopsy). Persistent spontaneous nipple discharge usually requires a microdochectomy or single-duct excision. The duct in question is removed to examine the duct under the microscope to rule out significant abnormalities/pathologies and correct the problem.
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