Supernumerary nipples

Last revised by Daniel J Bell on 26 Aug 2021

Supernumerary nipples, also known as accessory nipples or polythelia, are a common congenital malformation. The nipples may be either along the embryonic milk lines or beyond the milk lines, the latter type are called ectopic supernumerary nipples. Much more rarely, the nipples appear with complete breast tissue and ducts, this is known as polymastia.

Supernumerary nipples may be found in association with many syndromes and other conditions:

May remain undetected. Occasionally, the supernumerary nipple is noticed when hormonal changes during adolescence, menstruation, or pregnancy cause increased pigmentation, fluctuating swelling, tenderness, or even lactation.

Between the fourth and fifth weeks of embryogenesis, an ectodermal thickening forms symmetrically along the ventral lateral sides of the embryo. This epidermal ridge extends from the axillary region to the inner side of the thigh to form the embryogenic milk (or mammary) line. During the second and third embryogenic months, the glandular elements of the breasts are formed near the fourth and fifth ribs, with regression of the rest of the thickened ectodermal streaks. In the case of failure of a complete regression, some foci may remain to result in a supernumerary nipple. This can develop into a supernumerary complete breast (polymastia).

Usually no treatment is required; however, a protruding embarrassing supernumerary nipple can be removed surgically, if desired. Removal using liquid nitrogen cryotherapy has also been described.

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Cases and figures

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