- Often mistaken for moles, supernumerary nipples are relatively common, minor congenital malformations.
- Polymastia refers to cases where extra nipples appear along with partially formed breast tissue or breast ducts.
- A plastic surgeon can remove a supernumerary nipple by excising it under local anesthetia.
Many people are unaware that they have extra nipples, as they often appear as little bumps or innocuous looking growths.
If you suspect that you may in fact have a supernumerary nipple, read on. The following provides answers to some of the most common questions on this topic, with more than a little help from Suzanne Trott, MD, a board-certified plastic surgeon in Beverly Hills, California.
Does a third nipple look the same as a regular nipple?
Some third nipples do look like typical nipples, but many do not. Usually, they are not completely developed but do have features of a nipple that may look familiar upon close inspection, such as ridges or bumps. This is how to distinguish a third nipple from a mole or a birthmark, both of which are usually flat and lack ridges or bumps.
A classification for the different categories of third nipples was established in 1915. According to the National Institutes of Health (NIH), it is still valid today, as follows:
- Supernumerary nipple with no other tissue or features (this is the most common)
- Supernumerary nipple with areola but no other features (polythelia areolaris)
- Complete supernumerary nipple – a nipple that includes the areola and glandular breast tissue
- Supernumerary nipple with glandular tissue but no areola
- Supernumerary nipple with areola and glandular tissue but no nipple
- Glandular tissue only
- Supernumerary nipple with nipple, areola and pseudomamma (fat tissue in place of glandular tissue)
- Patch of hair with no other features (polythelia pilosa)
Why do some people have a third nipple?
Extra nipples are congenital, meaning they form during the development of an embryo, i.e. prior to birth.
These malformations occur along the milk line, an area of development that extends from the inner thigh to the axilla (armpit).
The milk line is comprised of skin tissue that thickens during the first weeks of pregnancy. Part of it forms the nipples, while the remainder becomes normal soft tissue at a later stage in the embryo’s development.
Supernumerary nipples occur when portions of the milk line’s ridges fail to transform into normal tissue again. In some cases this leads to the formation of third nipples in areas where the tissue remained thick, with defined ridges after birth.
How common is it?
Third nipples are not as rare or unknown as one might think. They have been documented since antiquity and mentioned in legends and mythology even earlier.
A related condition, polymastia (an extra breast gland), was seen in ancient times as a sign of heightened fertility and femininity. Artists even depicted goddesses with multiple rows of breasts. In men, additional nipples have sometimes been viewed as a sign of virility that gave them special powers. Legend also has it that King Henry VIII’s wife, Anne Boleyn, had a third breast.
According to the NIH, the incidence of third nipples varies by geography. For example, 5.6 percent of German children have supernumerary nipples while only 0.22 percent of the Hungarian population has them, despite the geographic proximity of these two populations.
The prevalence of third nipples is similar in females and males.
Can a supernumerary nipple produce milk?
Third nipples can, in fact, lactate, particularly if they are fully developed — and not only in women.
“Polythelia is the presence of an extra nipple, but it can range from just a nipple to a complete breast, which can lactate because it contains mammary glands,” says Trott. “The nipple alone cannot lactate but the gland can. Usually, however, polymastia (additional mammary glands) occur in the armpit area, also know as the axilla.”
Trott says she has never encountered a complete third breast with a nipple. However, she has seen axillary breast tissue.
“Usually the axillary breast tissue doesn’t have a nipple, so it can’t lactate, but it does swell and change as the normal breast does with menstruation in women,” she notes. “An extra nipple alone will not lactate, but theoretically if there is breast tissue and a nipple, it could lactate.”
Can it cause cancer?
No, a supernumerary nipple does not put a person at increased risk of cancer, and it cannot cause cancer. However, in some cases it can be an indication of an underlying disease or condition, such as a tumor or cancer.
What should I do if it hurts?
If a supernumerary nipple is causing you pain or discomfort — whether due to the fact that it’s lactating or otherwise — you should visit your doctor to see if there is a treatment or surgical option that might help.
One way to make sure you’re on top of any potential issues stemming from a third nipple is to schedule annual physical examinations. This will allow your physician to monitor the status of the nipple and look for signs of irregular growths or changes in the nipple and surrounding area.
While a supernumerary nipple cannot cause cancer, changes to the tissue can be a sign of disease, including cancer. Contact your doctor immediately if a supernumerary nipple develops new bumps, lumps, rashes or hard tissue.
Can a third nipple be removed?
Yes. According to Trott, a plastic surgeon can remove a supernumerary nipple by excising it under local anesthetic in his or her office.
“Usually a triple nipple looks just like a mole, and is removed like one, by excising it,” she says. A quick and simple outpatient procedure can remove supernumerary nipples with very little pain or downtime.
Typically, this isn’t necessary for health reasons, as supernumerary nipples usually aren’t a sign of an underlying condition, nor the root cause of any medical conditions. However, you may want to have them removed for cosmetic reasons.
Nipple removal surgery is relatively inexpensive. Ask your plastic surgeon for more information about the cost of third nipple removal surgery.
Will removing it leave a scar?
“Yes, it does leave a small scar,” says Trott. “Anytime an incision is made it will leave some kind of scar. How noticeable a scar depends mostly on how a patient heals, which often has to do with skin type.”
Can a third nipple develop later in life?
“No, it cannot develop later in life,” says Trott. “This is a variation of development of the embryos.”
However, it’s important to reemphasize that if you have a supernumerary nipple it could go through changes just like any nipple or breast. The changes can be physiological, a side effect of hormonal changes during puberty, or occur as a result of other causes.
I have what appears to be a third nipple on my foot. Is this possible?
According to Trott, a third nipple is usually located on the milk line. However, it can appear just about anywhere on the body, including the feet or hands. This type of supernumerary nipple is known as an ectopic supernumerary nipple, and is quite rare.