Pathological/acquired nipple inversion after puberty or breast development is more worrisome for malignancy or other abnormalities. To grade the inversion, digital manipulation is generally attempted. Many patients come for correction/ treatment when faced with lactational difficulties. If they do not resolve with puberty, they will often persist, and repair may be indicated for breastfeeding, psychosocial, or cosmetic reasons in adulthood. They do not tend to cause any problems then and are usually observed until puberty/adolescence for resolution.
Many inverted nipples present in pre-pubescent patients will resolve spontaneously during puberty. Congenital nipple inversion is mainly diagnosed during a wellness regular physical by a pediatrician or general practitioner as the patient approaches puberty.
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