Most people have two nipples. But about 1 in 18 people have a third one, and many of them don’t even know it. Supernumerary nipples, sometimes called accessory nipples, are far more common than the average person assumes. They can look like a small mole, a raised bump, or a fully formed nipple with pigmented areolar skin around it.
For some people, a third nipple is nothing more than a curiosity. For others, it causes real self-consciousness, especially when it sits in a visible location on the chest or abdomen. And in certain cases, accessory nipples come with underlying breast tissue that can swell, become tender, or even grow noticeably during hormonal shifts.
Dr. Babak Moeinolmolki, MD, a dual board-certified surgeon (American Board of Cosmetic Surgery and American Board of General Surgery) in Los Angeles, regularly treats patients who want supernumerary nipples removed. Because his practice focuses on the male chest, he sees a higher concentration of these cases than most surgeons do and understands the anatomy involved.
How supernumerary nipples develop
During early embryonic development, a structure called the mammary ridge (also known as the milk line) forms along both sides of the body. This ridge runs from the armpit area down through the chest, across the abdomen, and into the groin. In most people, the ridge regresses almost entirely, leaving behind only the two normal nipples. When part of the ridge fails to regress completely, the leftover tissue can develop into a supernumerary nipple.
The StatPearls reference on supernumerary nipples confirms that these structures follow the embryological milk line in the vast majority of documented cases. Less commonly, ectopic nipples can appear outside the milk line, on the back, shoulder, or even the thigh, though those presentations are rare.
Genetics play a role. If a parent has a supernumerary nipple, their children are more likely to have one too. The trait doesn’t follow a simple inheritance pattern, but there is a clear familial tendency in the medical literature.
Types of supernumerary nipples
Not all accessory nipples are the same. There are two main categories that matter from a treatment standpoint.
Polythelia refers to an extra nipple without any associated breast tissue underneath. This is the more common type. The extra nipple may look like a small raised bump with slight pigmentation, or it may be well-formed enough that it is clearly recognizable as a nipple. In polythelia, there is no glandular breast tissue beneath the surface.
Polymastia refers to an extra nipple that does have associated breast tissue. This is less common but more clinically significant. The underlying tissue can respond to hormones, meaning it can swell during puberty, grow during weight gain, or become tender with hormonal fluctuations. In men, polymastia can present similarly to localized gynecomastia.
The distinction between these two types affects how removal is performed. Simple polythelia can often be treated with a straightforward excision. Polymastia requires deeper tissue removal to address the glandular component underneath.
Supernumerary nipple or just a mole?
Many people with accessory nipples don’t realize what they have. A common scenario is someone who has always assumed a particular spot on their chest or abdomen was a mole or a skin tag, only to learn during a medical exam that it is actually a supernumerary nipple.
There are a few distinguishing features. Supernumerary nipples tend to sit along the milk line, running vertically from the armpit toward the groin. They often have a slightly different texture than surrounding skin, sometimes with a small central depression that mimics a normal nipple. Some have a faint ring of slightly darker skin around them, resembling a miniature areola. A mole, by contrast, is typically uniform in color and texture without those structural details.
If you are unsure, a dermatologist or surgeon can usually tell the difference on visual inspection alone. In ambiguous cases, ultrasound imaging or biopsy can confirm whether breast tissue is present beneath the surface.
When removal is recommended
There is no medical requirement to remove a supernumerary nipple that is not causing problems. Many people live their entire lives with one and never think about it. However, there are several situations where removal makes sense.
Cosmetic concern is the most common reason patients bring it up. A visible extra nipple on the chest or abdomen can cause embarrassment, particularly in situations involving bare skin like swimming, gym activities, or intimacy. The psychological impact is real and should not be dismissed. Multiple studies on body image and atypical anatomy show that even minor physical differences can significantly affect confidence and social behavior.
Discomfort or tenderness can occur when breast tissue is present beneath the accessory nipple. Some patients report cyclical soreness or swelling that correlates with hormonal changes. Others notice the area becoming increasingly prominent with weight gain.
The connection to gynecomastia is worth noting. Accessory breast tissue follows the same hormonal pathways as normal breast tissue. The aromatase enzyme, which converts testosterone to estrogen, is active in accessory breast tissue just as it is in the chest. Men who develop gynecomastia may also notice that their accessory nipple area enlarges simultaneously.
In rare cases, supernumerary breast tissue can develop pathology just like normal breast tissue, including fibroadenomas or other changes. While malignancy in accessory breast tissue is extremely uncommon, some patients prefer removal for peace of mind.
The removal procedure
For simple polythelia (an extra nipple without significant underlying tissue), removal is typically an office procedure performed under local anesthesia. Dr. Babak Moeinolmolki performs these procedures at his Los Angeles surgical facility, and most patients are in and out within an hour.
The area is numbed with a local anesthetic injection. The nipple and a small margin of surrounding skin are excised in an elliptical pattern. The wound is closed with sutures, and a small dressing is applied. The resulting scar is usually a thin line, roughly 1 to 3 centimeters long depending on the size of the original nipple.
When breast tissue is present underneath (polymastia), the procedure is somewhat more involved. The surgeon needs to excise not only the surface nipple but also the glandular tissue beneath it. This may require a slightly larger incision and, in some cases, liposuction of fatty tissue surrounding the gland. Dr. Moeinolmolki approaches these cases with the same precision he applies to male nipple reduction procedures, focusing on a smooth contour and minimal scarring.
For patients who are also undergoing gynecomastia surgery, accessory nipple removal can be performed during the same session. Combining procedures means a single recovery period and often a reduced total cost compared to scheduling them separately.
Recovery after accessory nipple removal
Recovery is straightforward for most patients. Simple excisions heal within 1 to 2 weeks. During the first few days, mild soreness and slight swelling around the incision site are normal. Over-the-counter pain medication is usually sufficient.
Sutures are either absorbable (dissolving on their own over 2 to 3 weeks) or non-absorbable (removed at a follow-up visit around 7 to 10 days after the procedure). Dr. Babak Moeinolmolki, MD, reviews each patient’s healing at a follow-up appointment and provides specific instructions for scar care.
Scar management is important during the first several months. Silicone-based scar sheets or gels can help the incision line flatten and fade. Sun protection over the scar is essential during the first year, as UV exposure can cause permanent darkening. Most patients find that the scar becomes barely noticeable within 6 to 12 months.
More involved excisions (those addressing underlying breast tissue) may have a slightly longer recovery. Some patients benefit from a compression garment over the area for a week or two, particularly if liposuction was part of the procedure.
Cost of accessory nipple removal
The cost of supernumerary nipple removal varies based on the complexity of the case. A simple excision under local anesthesia at an office setting is typically less expensive than a procedure that involves breast tissue removal at a surgical facility. During a consultation, Dr. Moeinolmolki’s team provides a specific quote based on the type of nipple, the amount of tissue involved, and whether any additional procedures will be performed at the same time.
Insurance coverage is uncommon for cosmetic accessory nipple removal. However, if there is documented breast tissue causing symptoms (pain, swelling, or other clinical concerns), some insurance plans may consider coverage. The office staff can help determine whether your situation qualifies. For more on surgical costs in Los Angeles, the practice provides detailed information during the consultation process.
Frequently asked questions about third nipple removal
Is a third nipple the same as a skin tag?
No. A skin tag is a benign overgrowth of normal skin, while a supernumerary nipple is actual nipple tissue that formed during embryonic development. They can look similar at first glance, but they have different structures. A supernumerary nipple often has a central depression and may have a faint areola-like ring around it. If you are unsure which one you have, a surgeon or dermatologist can tell the difference during a physical examination.
Does third nipple removal leave a noticeable scar?
The scar from accessory nipple removal is typically a thin line that fades significantly over several months. Because the nipple itself is usually small, the excision is limited in size. Proper scar care with silicone products and sun protection helps the scar become much less visible over time. Most patients report that the scar is far less noticeable than the original extra nipple was.
Can a supernumerary nipple grow back after removal?
When properly excised, the nipple tissue does not grow back. If breast tissue is present beneath the accessory nipple and is not fully removed during surgery, there is a small chance of residual tissue causing future concerns. This is why thorough excision by an experienced surgeon matters.
Is the procedure painful?
Local anesthesia numbs the area completely during the procedure. Most patients feel pressure but not pain during the excision. Afterward, mild soreness lasting a few days is common and manageable with standard over-the-counter medication. Patients generally describe the discomfort as minimal.
Can I have a third nipple removed at the same time as gynecomastia surgery?
Yes. Combining accessory nipple removal with gynecomastia surgery is common and practical. Both areas are addressed during the same session, which means one anesthesia event, one recovery period, and usually a lower total cost. Dr. Babak Moeinolmolki regularly performs combined procedures for patients who have both concerns.
How do I know if there is breast tissue under my extra nipple?
During a physical examination, a surgeon can often feel whether glandular tissue is present beneath the nipple. If there is any question, ultrasound imaging can clearly show whether breast tissue exists under the surface. This distinction is important because it determines the surgical approach needed for complete removal.