Gallbladder and Pregnancy

What is the gallbladder?

The gallbladder is a small, sac-shaped organ that sits just beneath the liver. Its purpose is to store bile, a substance that helps digest fats. As food enters the small intestine from the stomach, the gallbladder receives a signal to start contracting and release bile into the intestine.

Bile is composed of water, bile salts, and cholesterol, among other things. If the bile contains too much cholesterol and not enough bile salts, or the gallbladder doesn't empty properly, the gallbladder can form deposits, known as stones or gallstones. These stones are one form of gallbladder disease, but you can have stones and not notice any symptoms.

The term "gallbladder disease" covers inflammation, infection, stones, and blockage of the gallbladder.

What is biliary colic?

Biliary colic is the result of a blockage in the ducts of the gallbladder. If the bile is unable to exit the gallbladder, perhaps because of a gallstone, it can lead to inflammation or infection. And since the bile isn't entering the small intestine, the fat in the diet doesn't get broken down during digestion, and this can cause pain in the upper abdomen and back, as well as nausea and vomiting.

Biliary colic creates a sharp pain in the upper part of the abdomen that appears one to two hours after a meal that's high in fat. (Because dinner is usually the heaviest meal, the pain is more likely to occur at night.) The pain can last from a few minutes to several hours.

Some people also have pain between the shoulder blades or underneath the right shoulder. In addition to pain and nausea, biliary colic can cause gas, abdominal bloating, sweating, chills, or fever.

How does pregnancy affect the gallbladder?

Pregnancy hormones, particularly progesterone, cause muscular tissue throughout the body to relax, and this affects the gallbladder as well. The release of bile slows, and bile that doesn't get released can lead to the development of gallstones. Pregnant women who already have gallstones run a higher risk that these stones will block the release of the bile.

The problem in detecting the beginning of gallbladder disease during pregnancy is that the symptoms may be confused with morning sickness. However, if symptoms persist beyond the first trimester, or if you or your doctor suspects gallbladder-related problems, your doctor will likely recommend an ultrasound. Ultrasound is the most effective way to diagnose a gallbladder condition.

Of course, if you've had gallbladder problems before, let your doctor know so he can monitor you during pregnancy and prevent the disease from getting worse.

Am I at risk for gallbladder disease?

Women are far more likely to develop gallbladder disease than men are. You're more likely to develop gallbladder disease if you have a family history of the disease, are overweight (even if only moderately), have a high fat or high cholesterol diet, have diabetes, or are of Mexican or Native American origin.

Gallbladder disease used to be known as an older woman's affliction. But with more obesity among younger women, more younger women are being diagnosed with gallbladder disease.

Symptoms of gallbladder disease are more common in the third trimester or after delivery, but those at higher risk can develop the symptoms earlier in pregnancy.

Will gallbladder disease affect my baby?

Deposits or stones have no direct effect on your baby. However, your baby could be affected by the consequences of the disease. For instance, if you develop an infection, inflammation, or nausea and vomiting, these conditions can hinder your ability to nourish yourself and pass along adequate nutrition to your developing baby.

How is gallbladder disease treated during pregnancy?

In general, the goal of treatment during pregnancy is to reduce the symptoms and complications, and then treat the disease itself after pregnancy.

The first step in treating an inflamed gallbladder is to change your diet and eat fewer fatty foods. This means that the gallbladder will have to work less. For many women this step alone may be enough to relieve the symptoms. Regular exercise can also be helpful.

If your doctor prescribes a drug for a gallbladder problem and it doesn't provide adequate relief, he'll evaluate the effects of the disease and the risks of surgery. Given the risks, any surgery during pregnancy is generally avoided. But if the inflammation is severe, if there's an infection, or if the colic is acute, an operation may be necessary to prevent more serious complications.

If you need gallbladder surgery, it will probably be done laparoscopically. The surgeon makes two small abdominal incisions, inserting surgical instruments and a laparoscope. The laparoscope has a tiny camera that transmits a picture of the organs to a video monitor.

The gallbladder can then be removed without having to create a large incision. This means less pain and an easier recovery.

Can I develop gallbladder problems after pregnancy?

It's not uncommon for gallbladder disease symptoms to appear two to four months after delivery. This may be because pregnancy hormones aggravated the problem during the preceding nine months. Changes in your hormone levels after delivery may also be the culprit.

Gallbladder problems may also result from rapid weight loss after delivery. When you burn fat quickly, extra cholesterol accumulates in the bile, which can lead to gallstones.

To reduce your risk of developing gallstones after pregnancy, eat a high-fiber diet that includes plenty of fruit, vegetables, and whole grains. Try to keep your postpartum weight loss to no more than 2 pounds a week. And get plenty of exercise.

If you had gallbladder disease that was controlled during pregnancy and no surgery was required, it's important to have a follow-up evaluation. Symptoms can occur in the postpartum period or later in life, so have an evaluation when you're not in pain. Your doctor may recommend that you have the gallbladder removed to avoid an emergency situation later.

Source: BabyCenter

 

Torticollis in babies

Torticollis, or wryneck, literally means "twisted neck" in Latin. You may have woken up with torticollis after an uncomfortable night of sleep. In newborns, torticollis can happen due to positioning in the womb or after a difficult childbirth. This is called infant torticollis or congenital muscular torticollis.

It can be upsetting to see that your baby has a tilted head or difficulty turning his or her neck. But most babies don't feel any pain as a result of their torticollis. And, fortunately, the problem usually gets better with simple position changes or stretching exercises that can be done at home.

Torticollis is relatively common in newborns. Boys and girls are equally likely to develop the head tilt. It can be present at birth or take up to 3 months to develop.

No one knows why some babies get torticollis and others don't. Most doctors believe it could be related to the cramping of a fetus inside the uterus or abnormal positioning (such as being in the breech position, where the baby's buttocks face the birth canal). The use of forceps or vacuum devices to deliver a baby during childbirth also makes a baby more likely to develop torticollis.

These factors put pressure on a baby's sternocleidomastoid (stir-noe-kly-doe-MAS-toyd) muscle (SCM). This large, rope-like muscle runs on both sides of the neck from the back of the ears to the collarbone. Extra pressure on one side of the SCM can cause it to tighten, making it hard for a baby to turn his or her neck.

Signs and symptoms

Babies with torticollis will act like most other babies except when it comes to activities that involve turning. A baby with torticollis might:

tilt the head in one direction (this can be difficult to notice in very young infants)
prefer looking at you over one shoulder instead of turning to follow you with his or her eyes

if breastfed, have difficulty breastfeeding on one side (or prefers one breast only) work hard to turn toward you and get frustrated when unable turn his or her head completely

Some babies with torticollis also will develop a flat head (positional plagiocephaly) on one or both sides from lying in one direction all the time. Or they might develop a small neck lump or bump, which is similar to a "knot" in a tense muscle. Both of these conditions tend to go away as the torticollis gets better.

If you think your baby might have torticollis, ask your doctor to perform a physical examination on your baby, which involves seeing how far your baby can turn his or her head.

If a diagnosis is made, the doctor might teach you neck stretching exercises to practice with your baby at home. These exercises help loosen the tight SCM and strengthen the weaker one on the opposite side (which has weakened due to underuse). This will help to straighten out your baby's neck.

In certain cases, the doctor may suggest taking a baby to a physical therapist for more intensive treatment. After treatment has started, the doctor may examine your baby every 2 to 4 weeks to see how treatment is going.

If your baby is 6 weeks of age or younger and also has signs of an unstable hip, the doctor might order an ultrasound to see if your baby also has developmental dysplasia of the hip.

Although most torticollis cases are not related to other medical problems, congenital muscular torticollis can happen in children who have infections, fractures, reactions to certain medicines, or genetic conditions like Down Syndrome or Klippel-Feil Syndrome. If your child has torticollis and you are concerned that other medical problems may be present, talk to your doctor.

Treatment at home

The best way to treat torticollis is to encourage your baby to turn his or her head in both directions. This helps loosen tense neck muscles and tighten the loose ones. Rest assured that babies cannot hurt themselves by turning their heads on their own.

Here are some exercises to try:

When your baby wants to eat, offer the bottle or your breast in a way that encourages your baby to turn away from the favored side. (Use your child's desire to eat to encourage him or her along!)

When putting your baby down to sleep, position him or her to face the wall. Since babies prefer to look out onto the room, your baby will actively turn away from the wall and this will stretch the tightened muscles of the neck. Remember to always put your baby to sleep on his or her back, as this helps reduce the risk of SIDS.

During play, draw your baby's attention with toys and sounds to make him or her turn in both directions.

Don't Forget "Tummy Time"

Laying your baby on the stomach for brief periods while awake (known as "tummy time") is an important exercise because it helps strengthen neck and shoulder muscles and prepares your baby for crawling.

This exercise is especially useful for a baby with torticollis and a flat head — and can actually help treat both problems at once. Here's how to do it:

Lay your baby on your lap for tummy time. Position your baby so that his or her head is turned away from you. Then, talk or sing to your baby and encourage him or her to turn and face you. Practice this exercise for 10 to 15 minutes.

Outlook

Most babies with torticollis get better on their own through position changes and stretching exercises. It might take up to 6 months to go away completely, and in some cases can take a year or longer.

Stretching exercises to treat torticollis are most likely to work well if started when a baby is between 3 to 6 months of age. If you find that your baby's torticollis is not improving with stretching, talk to your doctor. Your baby may be a candidate for muscle-release surgery, a procedure that cures most cases of torticollis that don't improve with physical therapy alone.

A Mother's Gift

A Mother's Gift

by Janette Fisher 

From the very first time, you hold your child
Their first gift is your heart forever,
The love you give and they return
Is the bond that will hold you together

Throughout their life, your love will be
A light that guides their way
The beacon aglow in the darkness
Should they ever go astray

Your love will give them courage
When the way ahead is unclear
And will give them strength, when needed
To help overcome their fears

Your love will accept them for who they are
Whatever they say or do,
Your love will forgive unreservedly
Because they are a part of you

It's a love that will know no barriers
Have no bounds, no expectations
Your love will be unconditional,
Pure, with no complications

A love that remains as constant
As the stars in the heaven above
A gift no money on earth can buy,
The gift of a mother's love.

5 Way Pregnancy After Miscarriage is Different!!

1. Fear of the unknown. When I became pregnant with my daughter, I dreaded my first prenatal visit. Relief at seeing a heartbeat quickly turned to panic at learning my progesterone levels were low. As I filled the supplement prescription, I felt myself being submerged into an all-too-familiar nightmare. After each appointment, I waited to learn my "levels" like a prisoner waiting to hear her sentence. I felt trapped in a body that didn't work, that couldn't hold on to what mattered most. Even when I made it past the first trimester, my hesitations continued, shrouding every moment in a layer of anxiety and fear.
2. Loneliness. With my first pregnancy, we told our families right away. It was Christmas, and we were celebrating. I never dreamed I would be un-telling everyone a month later. With my next pregnancy, I was determined not to make the same mistake. We waited a long time before telling anyone, which made me feel protected, but also alone. My pregnancy became a secret to keep, instead of happy news to share. I held everything inside -- exactly when I needed my friends and family the most.
3. Guilt and self-doubt. During this time I often questioned my decisions, worried that any lapse in judgment might end my pregnancy. I was nervous to lift chairs at a work event, scared to help a family member carry luggage up the stairs. (Positions I found myself in because I was too afraid to tell anyone I was pregnant.) When you've had a miscarriage, it's easy to grab hold of the idea that by doing everything "right" you have some semblance of control -- and, by doing something "wrong," you're to blame for the loss. It's a heavy burden to bear.
4. Morning sickness envy. Most women dread morning sickness. I found myself longing for it. I craved the physical reassurance that things were "normal" inside me. I desperately wanted to know that my baby was there, growing and developing as expected. My lack of morning sickness felt like a punishment. Every moment I didn't feel nauseous was a reminder of how little I understood what was happening inside of me -- and how little I could control it.
5. Fear of joy. For a long time, I found myself prefacing every statement about my baby with "If we make it through the pregnancy" or "If the baby is born." I was afraid to be excited, terrified of letting in too much joy. I was uncomfortable buying furniture for the nursery, shopping for onesies, or even thinking of names. Looking back, I wish I had let myself enjoy it more. But my wounds were still fresh. I didn't want to indulge hopes that might lead to another heartbreak.
Sometime in my ninth month I began to relax, to feel hopeful that soon I'd hold my baby in my arms. I stopped saying "if" and started saying "when." When my daughter was born, I knew she was the baby I was meant to have. But as blessed as I am with my children, when I hear of a friend's miscarriage, I feel a pang in my heart. I'm glad that there's a day to shine a light on this issue -- for people to acknowledge and share their sadness about such a difficult subject. It was this openness -- talking with others who'd been through it -- that helped me get through those nine long months. Hopefully this openness will help others to know that there's light -- and even hope -- beyond the darkness.

Readings

Twin Pregnancy

One of the first questions a newly pregnant mother often asks is “Am I having twins?” And until it is confirmed that only one embryo is present, there is always the potential for this to be true.

For women who have a family history of twins, who have previously conceived with twins or have had fertility assistance, then the likelihood of having twins is higher. Because some types of fertility assisted conception do increase the likelihood of having a multiple birth, this is usually raised very early on in the pre-conception assessment and consent phases of treatment.

I’m having what?

Some women view the thought of having twins as being an absolute highlight, but others dread the possibility. Your own perception will be influenced by your personal experiences, history and supports.

For women who have been informed of the risk, or who have a history of twins in their biological family, having their own twin pregnancy confirmed is not such a shock. But for women who did not expect to conceive with more than one baby, or who may not having been planning to conceive at all, then finding out they are pregnant with twins can come as a real surprise.

Denial, shock, feeling numb and even angry are common emotions in the early days of having a twin pregnancy diagnosis. But with time reality soon descends and most women just learn to accept the fact that they are having two babies.

What’s so different about being pregnant with twins?

Twin pregnancy symptoms are not so much different to normal pregnancy symptoms, but they are felt much earlier. For the stage of gestation, twin pregnancy symptoms tend to be felt more clearly and with more emphasis before the normal gestational age and stage.

It is important to remember that just as every woman is unique and her pregnancy highly individual, there are some “classic” or standard symptoms which are attributed to twin pregnancy. Many of these are due to the elevated and more concentrated levels of hCG (Human Chorionic Gonadotrophin Hormone) which is the pregnancy hormone. It is primarily responsible for sustaining the embryo and maximising its chances of survival.

When twin pregnancy is more likely

For women over 30 years of age. In women who are peri-menopausal twins are more common.

In women who are taller than average, the odds are higher for having a twin pregnancy than for those of average or shorter height.

Women who are overweight with a BMI (Body Mass Index) of >25.

If you have a history of already having twins or if there are twins in your biological family e.g. your mother, aunts or sisters have had non-identical (fraternal) twins.

If you have had fertility assistance to conceive.

If you are of African American descent.

For women who have been pregnant previously.

Symptoms of twin pregnancy

Some women will “just know” they are pregnant with twins. This may be before they have even had confirmation that they are pregnant. They may dream, sense or have a vision or inherent belief that they are pregnant with twins.Some women will be told they are pregnant with twins by their partner, relatives, family or very close friend. Although there is often no evidence to support this claim, when their twin pregnancy is confirmed it really comes as no surprise.

Feeling very nauseous from early in the pregnancy. This is sometimes so extreme that the mother finds it difficult to tolerate anything but the blandest, easiest to digest foods.

Extreme intolerance to foods, smells, textures and appearance of some foods. Commonly meat, seafood, coffee and tea are the first substances to be found repugnant.

The uterus is “large for dates” which reflects the fact that two embryos, rather than one is present.

Extreme breast tenderness – to the point where it may be too uncomfortable to wear a bra. Some women find they need to wear crop tops or bandeau style tops as an alternative until their breasts become more comfortable.

Wanting and needing to pass urine much more frequently. Although urinary urgency is a common early pregnancy symptom, when pregnant with twins, this is much more magnified.

Utter exhaustion and a feeling of being unable to get through each day. This again, is a common pregnancy symptom but is exacerbated during a twin pregnancy.

Higher levels of hCG. This may be reflected in a very early pregnancy urine test. Even before a missed period, the level can be so high that there is an immediate, strong and clear positive confirmation on the pregnancy testing stick. For women who have undergone fertility assistance, blood tests may reflect a very high concentration of hCG early after conception.

Some women will experience more uterine cramping which is not associated with any blood loss. This can be a symptom of round ligament pain and is due to the uterus expanding relatively quickly.

A sense that your heart has to work harder than it usually does. Many women are aware that their resting heart/pulse rate is higher than normal. This is a sign of their heart having to pump out a greater blood volume with each heart muscle contraction in order to supply the uterus with oxygen saturated blood.

Moodiness, being prone to tears and feeling mentally unstable. Again, labile moods are a common pregnancy symptom, but when pregnant with twins, they tend to be more extreme.

You may find you can feel your baby/babies moving much earlier in your pregnancy. Women who are pregnant with twins say that they are conscious of feeling movements, known as quickening, earlier than the standard 15-16 weeks.

How is a twin pregnancy confirmed?

Although you, your partner or your health care practitioner may suspect you are pregnant with twins, it is not until twins are confirmed that you can be 100% sure.

Ultrasound, where two embryos are clearly defined on the screen.Hearing two, separate heartbeats on a Doppler.In the absence of sound ante-natal care, it is still possible that a twin pregnancy may not be evident until two babies are born.

Complications of a twin pregnancy

Unfortunately, the overall risks of pregnancy are increased during a twin pregnancy. But many women have an uneventful gestation and just because you are pregnant with twins, is not a guarantee you will have complications. But it does help to be informed and keep an open mind.

Premature birth – e.g. before 38 weeks of gestation.

Smaller babies with lower birth weight – simply because there have been two growing in the same space. One baby which is smaller than the other. It is common during twin pregnancy for one twin to receive more nutrition and space allocation than the other.

Preeclampsia.
This is why it is so important for you to have your BP monitored during your pregnancy. Fluid retention and passing protein in urine are other signs of preeclampsia.

Gestational diabetes.

What’s important to remember if pregnant with twins

Regular ante natal care with a qualified health care practitioner is essential.It may be worthwhile seeing an accredited practicing dietician to receive evidence based information on diet and meeting your body’s nutritional demands.

Allow yourself plenty of opportunity to rest. Growing twins and supporting them towards maturity takes a lot of energy. You may need to consider your work/leave entitlements and arranging regular home support and child care for older children.

You may need to have more regular ultrasounds than if you were carrying one baby.Your healthcare rebate and entitlements may be affected; find out early in your pregnancy what you are covered for, or consider accessing the public health system. Premature baby care can be extremely expensive. Find out your status and coverage early in your pregnancy to avoid unwanted and avoidable expenditures.

Plan for an earlier than expected delivery. Twins have a habit of coming early and it pays to be well organised.

Sex After C Section.

Regardless of the process you use to give birth (through a C section or normally) your body requires time to heal. According to many healthcare experts, you need at least six weeks of rest before you can have sex again. This is ample time for your cervix to close, any tears/repaired lacerations to heal, and for your post-delivery bleeding to cease.

You can also opt to wait longer before having sex if you feel the need to. Actually, some women will resume sex only a few weeks after giving birth while others prefer waiting longer than the six weeks. Some factors that can cause further delays in resuming your sex life include fatigue, fear of pain and stress. There are also many tips you can take while trying sex after c section to make the experience more pleasurable.

When to Have Sex after C Section

If you recently gave birth through a C section, it is normal to have doubts and questions regarding the appropriate time to resume your sex life. Most women assume they can have sex immediately since they did not give birth the normal way. However, this is very far from the truth.

After undergoing a C section, it is also required that you wait for at least 6 weeks before resuming sex. Actually, it is best to wait until your next doctor’s appointment before you resuming. During this checkup, the doctor will assess your incision and the healing process. They will also want to ensure that your post-delivery bleeding has stopped before they can give you the go ahead to have sex.

Is Sex Painful After C Section

Normally, you are bound to experience some pain during sex after having a C section. Some women complain of painful sex even after visiting the doctor and being given a go ahead for having sex. The type of pain mostly experienced by women during sex after a C section is more of a burning sensation than a stretching pain. Most women think that the pain is caused by abnormality in the vaginal path. However, if there were any abnormalities, the doctor should be able to pick it up during the six weeks examinations.

Some women who have had C sections for more than one child complain of painful sex each time they resume the activity after a C section. However, the pain ends after a few times. Using lubrication can go a long way towards easing the pain and discomfort. If you happen to experience discomfort and pain during sex, you can ask your partner to remain still until the pain subsides. Once the pain stops, you will be able to enjoy sex again.

On the other hand, if you feel that the pain is too much to bear, you can consider holding out for a few more weeks without sex before resuming. This gives your body more time to heal properly. After a few weeks, you will be able to enjoy sex without the pain.

Tips on Sex After C Section

If you decide to have sex as soon as your six weeks are up, there are tricks you can use to make it easier for your body and your healing incision.

Start with the positions you find most comfortable. For example, side by side or spooning would be a good idea. This will put the least pressure on your abdomen, which is where the incision was done. The abdomen remains sore for a while and you're advised to put the least pressure on it. As you recover, you can try out other positions. During the recovery process, you should consider oral sex over intercourse. It is not only comfortable, but also safer. Ask your partner to be careful not to blow air into your vagina as it can enter the bloodstream, and this can be dangerous.

Extra (supernumerary or accessory) nipples or breast tissue

Extra nipples or breast tissue is fairly common (1-6% of women) and is a result of incomplete regression of the mammary ridge (milk line) during the development of the embryo before birth.

What causes this? Extra breast tissue is a common developmental variation in human anatomy. Breast development begins around week four of gestation, with two parallel lines of glandular tissue called the milk line (or mammary ridge) extending from slightly beyond the underarm area, down the chest and abdomen, to the groin area and ending near the groin at the inner sides of the thighs (see figure).  Breasts eventually develop from these lines of tissue, and the remaining tissue regresses. Occasionally, there is an incomplete regression of the mammary ridge during embryo development, andextra (supernumerary) nipples and/or breast tissue forms, usually along this line but occasionally in other parts of the body. This can occur in both males and females. An extra nipple, areola, and/or glandular tissue may be present anywhere along this line (a nipple without glandular tissue is most common), and it is not at all unusual to have more than one.

What is typical when it comes to extra breast tissue? The term hypermastia (or polymastia, or ectopic breast tissue) refers to the presence of accessory mammary tissue in addition to the two main glands. It can occur in a number of different forms. Some examples include:

breast tissue with a nipple and areolabreast tissue with a nipple but no areolabreast tissue without a nipple (hyperadenia)nipple without glandular tissue (hyperthelia or polythelia)areola without nipple or glandular tissuean ectopic milk duct that leaks milk through the skin without visible breast tissue or nipple

Extra nipples usually occur right below the breasts or in the underarm area, and extra mammary tissue is usually located in the underarm area. Most studies show extra nipples to be more common in males, and they can sometimes run in families.

Accessory, or supernumerary, breast tissue is not functionally connected to the breast at all, even though it may be near the breast, in the underarm area or anywhere else along the milk line. This isdifferent than the breast tissue that normally extends into the underarm area, called the Tail of Spence (see figure), which is connected to the main ductal system of the breast.

What does it look like? Accessory breast tissue can appear as a complete breast if both a nipple, areola, and glandular tissue are present. If mammary tissue without a nipple or areola is present, it may appear as a lump or swelling under the skin. An accessory nipple may look like a freckle, a mole or a dimple, or it may look like a typical nipple (though it is usually smaller). Often, accessory nipples or breast tissue are not noticed until hormonal changes make them more apparent. Sometimes a new mom will not know she has accessory breast tissue until she notices milk dripping from a “freckle” or pore in the skin.

What happens during pregnancy & lactation? The hormonal changes during pregnancy and lactation can cause accessory breast tissue to increase in size and/or produce milk. You may also experience fluctuating swelling and/or tenderness (this may also occur during adolescence and/or menstruation). Accessory nipples and areolas may darken.  If you experience skin irritation when clothing rubs against an accessory nipple, try covering it with a bandaid or gauze.

As with any breast tissue, accessory breast tissue can become engorged at the beginning of lactation, and may leak milk. Accessory breast tissue does not typically produce much milk, and does not interfere with breastfeeding. The usual methods for easing engorgement can be helpful. If the extra breast tissue is not drained by a ductal system (so that no milk can leak or be expressed), comfort measures such as cold compresses can help until the extra tissue involutes and stops producing milk. Mothers with leaking milk from accessory nipples have found that a breast pad or sometimes just a bandaid can be effective for catching leaks. As with any leaking, applying pressure straight in toward the chest may help stop the leaking.

Uncommon problems: Since this is breast tissue, it has the potential for the same problems as any other breast tissue, including  inflammation, mastitis, abscesses, cysts, benign lumps, or malignant changes. The accessory nipple or breast tissue can be surgically removed, but this is not necessary unless it is causing problems. Some people do have accessory breast tissue or nipples removed for cosmetic reasons.

Article from kellymom.com