Supernumerary nipple

A supernumerary nipple is an additional instance of nipple occurring in mammals, including humans. They are often mistaken for moles. Studies variously report the prevalence of supernumerary nipples as approximately 1 in 18 and 1 in 40.[2][3][1]

Supernumerary nipple
Other namesThird nipple, triple nipple, accessory nipple,[1] polythelia
SpecialtyMedical genetics, dermatology

The nipples appear along the two vertical "milk lines", which start in the armpit on each side, run down through the typical nipples and end at the groin. They are classified into eight levels of completeness from a simple patch of hair to a milk-bearing breast in miniature.[4][5]

Types
TypeGlandular tissueNippleAreolaFat tissueHair patch
1yesyesyesyes
2yesyes
3yesyes
4yes
5 ("pseudomamma")yesyesyes
6 ("polythelia")yes
7 ("polythelia areolaris")yes
8 ("polythelia pilosa")yes[6]

Polythelia refers to the presence of an additional nipple alone while polymastia denotes the much rarer presence of additional mammary glands.

Although usually presenting on the milk line, pseudomamma can appear as far away as the foot.[7]

A possible relationship with mitral valve prolapse has been proposed.[8]

Clinical significance

Clinical presentation

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.

Associations

It is said to be found in association with many syndromes and other conditions:

Treatment and prognosis

Most often 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.

Society and culture

Television

The Triple Nipple Club is a documentary shown on Channel 4 which explored the biological mystery of the supernumerary nipple.[9] First broadcast on 2 January 2008, it was directed and produced by Dan Louw and commissioned as part of Channel 4's First Cut series.[10] The film focuses on Louw's attempts to understand why he was born with extra nipples, a condition he shares with the likes of Mark Wahlberg,[11] Lily Allen,[12] and Tilda Swinton, as well as well known TV and film characters such as the Bond villain Scaramanga and Chandler Bing. Fascinated and confused by this seemingly pointless mutation, Louw sets off on a personal journey of discovery to try and unwrap "the riddle of the triple nipple". He starts out by consulting the man in the street and even a renowned teratologist, an expert in physical mutations. After testing the notion that extra nipples could be a sign of fertility, he discovers that they are actually an atavism, or evolutionary 'holdover' – a sign of how humans evolved.[13]

See also
  • Accessory breast
  • Grace Sherwood, sentenced to jail for witchcraft partly on the basis of having "two things like titts on her private parts of a black coller [color]"
  • Polydactyly

References
  1. Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
  2. [ https://link.springer.com/article/10.1007/s004310050944], Supernumerary nipples: prevalence, size, sex and side predilection – a prospective clinical study, H. Schmidt, European Journal of Pediatrics volume 157, pages 821–823 (1998).
  3. [ https://jamanetwork.com/journals/jamapediatrics/article-abstract/511138], Occurrence of Supernumerary Nipples in Newborns Francis Mimouni, MD; Paul Merlob, MD; Salomon H. Reisner, MB, ChB, Am J Dis Child. 1983;137(10):952-953.
  4. Kajava Y. "The proportions of supernumerary nipples in the Finnish population". Duodecim 1915; 1:143-70.
  5. Revis, Don R. Jr. "Breast Embryology". eMedicine. Retrieved 3 December 2007.
  6. Camacho F.; González-Cámpora R. (1998). "Polythelia pilosa: A Particular Form of Accessory Mammary Tissue". Dermatology. 196 (3): 295–298. doi:10.1159/000017924. PMID 9621135. S2CID 25211741.
  7. Conde, Délio Marques; Kashimoto, Eiji; Torresan, Renato Zocchio; Alvarenga, Marcelo (2006). "Pseudomamma on the foot: An unusual presentation of supernumerary breast tissue". Dermatology Online Journal. 12 (4): 7. doi:10.5070/D339n411b8. PMID 17083862. Retrieved 3 December 2007.
  8. Rajaratnam K, Kumar PD, Sahasranam KV (2000). "Supernumerary nipple as a cutaneous marker of mitral valve prolapse in Asian Indians". Am. J. Cardiol. 86 (6): 695–697. doi:10.1016/S0002-9149(00)01057-2. PMID 10980229.
  9. Throwback | First Cut: The Triple Nipple Club | Free Video Clips from Channel 4
  10. Channel 4 - FourDocs blog - First Cut line-up
  11. AskMen.com - Mark Wahlberg's third nipple love
  12. YouTube - Lilly Allen Third Nipple
  13. Salon | Why do men have nipples?
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