Supernumerary nipples, also known as accessory nipples, are the most freque
ntly encountered congenital anomaly of the breast. Once associated with fer
tility or divine powers, they are now widely held to be of cosmetic signifi
cance only. During the past 20 years, however, there has been a steady numb
er of articles reporting the suspected association of supernumerary nipples
with numerous benign and malignant medical conditions. We describe a previ
ously unreported accessory nipple variant occurring as a nevoid nodule surm
ounting an otherwise normal primary nipple. The patient was otherwise healt
hy. The embryogenesis of this anomaly is hypothesized to result from in ute
ro nipple dichotomy, rather than a failure of regression along the embryoni
c milk line.