Congenital nipple deformities usually do not require immediate treatment. Observation is critical when identifying and treating a congenital nipple deformity. Changes in their pigmentation may be treated with early excision and histopathological assessment. However, acquired nipple deformities are usually assessed for underlying causes, especially malignancy. Observation is critical when identifying and treating a congenital nipple deformity.
Nipple deformities can be surgically reconstructed with plastic surgery when necessary. Although these deformities rarely have a long-term effect on the function of the breasts, they can have a severe psychological impact on the individual, especially adolescents. Reconstructive surgery by a plastic surgeon is typically performed when breast development is complete and final breast tissue volumes have been achieved. Treatment of athelia is similar to the
nipple reconstruction procedures, with particular attention paid during reconstruction to the placement of the inframammary fold (i.e., the lower anatomical boundary of the breast) and re-creation of the
nipple. The reconstructed
nipple can be later tattooed to add
color and to create the
areola.
Inverted
nipples can sometimes cause difficulty with
breastfeeding, but treatment is rarely considered. Most of the time, skin-to-skin contact with the baby shortly after birth is desired to allow the baby to use its innate
reflexes, and feeding in a laid-back position can improve breastfeeding outcomes. Some individuals prefer to use a breast pump just before feeding to temporarily reverse the
nipple inversion or a reverse syringe device, with no needle attached, to help pull out the
nipple. If the baby cannot attach properly, trying to bring out the
nipple with one’s hands by pressing around the areola could also be helpful. Lastly, a
nipple shield is recommended for babies with
breastfeeding difficulties as it provides a more significant and firm point for the baby to
latch on during the feed.