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Inverted Nipples, Retracted Nipples, and Nipple Changes

Learn What is Healthy and When to Get Help

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Updated April 09, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Do you know the difference between inverted nipples, retracted nipples, and erect nipples? Inverted nipples may be normal for some women. Learn how to identify the variations on inverted, retracted, and erect nipples, and when to get medical help.

Normal Nipples and Nipple Variations

Nipples and areolas can vary in size, shape and coloration. "Normal" nipples are the ones you were given at birth - flat, puffy, shy, or prominent – they occupy a place of honor on your breasts. Nipples can change in response to hormonal changes during puberty, pregnancy and breastfeeding. Remember to examine your nipples as part of your monthly breast self-exam, as you check for changes. Know when to get medical help, if nipple changes occur. Let's take a look at some common variations on nipples.

Erect or Everted Nipples

Everted Nipple - Erect Nipple
Art © Pam Stephan

Most of us think of everted nipples – raised tissue in the center of your areola – as normal nipples.  Even when your skin is at normal body temperature, an everted nipple will stand out from the skin of your breast - even if it has not been stimulated.  It is held erect by a cylindrical column of small smooth muscles.  This type of nipple presents little difficulty for a breastfeeding mother and infant.  When everted nipples are stimulated by touch or cold, they may become erect.  Everted nipples are more prone to Jogger's Nipple, but with proper care, this can be prevented.

Inverted Nipples – Natural Causes

Inverted Nipple
Art © Pam Stephan

Inverted nipples appear to be indented in your areola, instead of standing up above the surface of your breast.  Nipple inversion is a condition that you are born with and it does not mean you have breast cancer. Inverted nipples can be coaxed out of hiding with some stimulation; plastic surgery can also be performed to reverse this.  Nipple inversion may occur because the nipples are stuck to scar tissue or the nipples may be connected to a short milk duct.

Retracted Nipples – Changed Position

Retracted Nipple
Art © Pam Stephan

Retracted nipples are a nipple change.  When your nipple starts out as raised tissue, but begins to pull inward, change position, or fold itself into a narrow crease, you have a retracted nipple.  A retracted nipple, unlike an inverted nipple, will not come back out when stimulated. Nipple retraction may be caused by aging, duct ectasia, or breast cancer. See your doctor if you notice nipple retraction, especially if only one nipple is affected.  A mammogram or breast ultrasound will help determine the cause of the nipple change, and help you get the proper treatment.

Bottom Line on Nipple Changes

Nipples, like the rest of our bodies, change as we grow, mature, and age.  It's good to know what is normal for your nipples.  Do keep up your monthly breast self-exam so you will recognize changes.  Keep an eye out for nipple discharge, lumps, blisters, or unusual pain.  Get help if you find an unexpected change in your nipples and areolas.

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Sources:

Understanding Breast Changes: A Health Guide for Women. National Cancer Institute. Posted: 09/28/2009

Nipple-Areolar Complex: Normal Anatomy and Benign and Malignant Processes. Brandi T. Nicholson, MD, Jennifer A. Harvey, MD and Michael A. Cohen, MD. March 2009  RadioGraphics,   29,  509-523.

Nipple retraction in duct ectasia. Rees BI, Gravelle IH, Hughes LE. Br J Surg. 1977 Aug;64(8):577-80.

Plastic Surgery.  Inverted Nipples; Pp. 76- 77.  Dr. Susan Love's Breast Book.  Susan M. Love, M.D.  Third Edition, 2000. 

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