And now we rejoin our continuing drama in episode #2: "As The World (of
inverted nipple etiology) Turns", as always anxious, young and restless
lactnetters, wonder with undulating anticipation: <<How and why would
adhesions develop in the breast?>>

        Congenitally inverted nipples can be a result of faulty development in the
fetal period. Persistence of the original invagination of the mammary dimple
occurs as it fails to become detached when the tissue underlying the mammary
pit does not proliferate as expected and push the nipple site out of it's
depressed position. These adhesions at the nipple-areolar junction bind the
nipple inward. The shorter lactiferous ducts can also tether the nipple,
preventing it from everting. The surrounding areolar mammillary tissue can
further retract the underdeveloped nipple. Congenitally malformed nipples
include the umbilicated and the invaginated types of inverted nipples.
        Nipple inversion is most often congenital in origin, but can also be
acquired. The acquired group includes ductal mastitis in early development,
breast surgery such as reduction mamoplasty, repeated inflammations,
carcinoma, tension caused by large pendulous breast, and trauma or
inflammation following pregnancy and lactation. These conditions can cause
the nipple to be depressed into the areola. Also, involution which in
nulliparous women begins sometime after age 30, can cause slit-like
retraction as the result of duct ectasia as the subareolar ducts dilate and
shorten.

As still unsatisfied Lactnetters dream of a day when there is not "Another
(inverted nipple in the) World", and wrestle with the "Guiding (principals,
procedures, and protocols) Light" of unfulfilled "General (prenatal and
postpartum management in the) Hospital", ideas welling and surging until they
erupt on the monitor screen, our drama will continue to ....unfold.

Deb
Springfield,VA