Patient's question:
The left nipple hasn't developed. How can it be treated? What kind of impact will it have in the future?Doctor's answer:
Hello, the breast must not only have a proper shape and size but also must include the nipple and areola. The nipple is the part where the infant suckles milk, and it is sacred to the mother. Moreover, only breasts with normal nipple and areola size, shape, and position are considered perfect. If a mature female's nipple is concave and indents below the surface of the areola skin, not protruding above the plane of the areola, causing the area to resemble an opening, it is called nipple inversion. The degree of nipple inversion varies; some cases only show retraction of the nipple, while severe cases may involve the nipple being concave or even inverted. Nipple inversion not only affects the aesthetic appearance of the breast but also hinders breastfeeding function. The affected area is difficult to clean, and the indented part can easily accumulate dirt and cause local infections. Since the breast ducts communicate with the, inflammation can spread to the breast tissue, leading to mastitis. Therefore, correction is necessary.Nipple inversion is primarily congenital but can also be caused by trauma, surgery, breast tumors, or fibrosis after mastitis. The main reason for congenital nipple inversion is poor development of smooth muscle in the nipple and areola. These muscle fibers pull inward, and combined with a lack of supportive tissue beneath the nipple, this results in nipple inversion. Inversion typically occurs bilaterally but can also affect one side. If the inverted nipple can be gently pushed or pulled back out, it is considered mild nipple inversion, also known as correctable nipple inversion. Correction for this type of inversion can be achieved through non-surgical conservative treatments, with the best timing being before marriage or in the early stages of pregnancy. Specific methods include manual traction and mechanical traction.
Manual Traction: Gently pinch the nipple between the thumb and forefinger in a horizontal or vertical direction and pull it outward continuously or intermittently for about 30 minutes. Alternate between both nipples. Perform this 3–5 times daily.
Mechanical Traction: Use a manual or electric breast pump to apply negative pressure and pull the nipple out. The same duration and frequency apply—30 minutes per session, alternating between both nipples, 3–5 times daily.
Both methods can yield good results after about two months.
Irreversible Nipple Inversion (Severe Cases): For this type of inversion, surgical correction is the only option. The surgery involves completely releasing the pulling muscle fibers and filling the area beneath the nipple with surrounding tissue to enhance support, lifting the nipple, and reshaping it. The procedure is typically performed under local anesthesia, with various techniques available depending on the specific condition. The surgery is conducted within the areola range, leaving minimal scarring. In normal cases, it does not damage the sensory nerves of the nipple, so post-surgery, the nipple retains its normal sensation. The surgery generally does not disrupt breast ducts, so breastfeeding is not affected.
It is worth noting that even after surgical correction, there is a possibility of recurrence. Therefore, after the stitches are removed (5–7 days post-surgery), manual traction should be continued for 1–2 months. Those with access to mechanical traction may also use it to reinforce the results and prevent recurrence.
If a person is born without a nipple, reconstructive surgery can be performed. This condition may have some impact on both sexual life and breastfeeding.