I'm 20 yrs old male who have puffy nipples but not sure if it is gynecomastia. What treatment would you recommend? (photos)

I have them since I was 16, but was obese too. My height is 168 and weight is 69 currently and just started working out. Would really like to know if working out and having a clean diet would get rid of those puffy nipples? My diet would include broccoli everyday and also other foods that would boost up my testosterone.

Doctor Answers (8)

Gynecomastia

+2
Puffy nipples usually is a result of gynecomastia.  Often times a patient will complain that the nipple only looks puffy when warm, when they are cold, the constriction of the areola may flatten it out.  It's impossible to know for sure without a physical exam, but many of my puffy nipple patients seem more likely to need direct excision of a glandular bud or lump of breast tissue.  Some need liposuction as well for best contour.  While impossible to say for sure, I would guess that your skin will shrink up nicely and you will get a nice result.  Be sure you see a board certified plastic surgeon with a special interest in gynecomastia.  Every case can have its own peculiarities and it's best to see someone with a wide experience.  Best of luck,


Nashville Plastic Surgeon
4.5 out of 5 stars 17 reviews

I'm 20 yrs old male who have puffy nipples but not sure if it is gynecomastia. What treatment would you recommend?

+2
Thank you for the question and pictures. Given that the “puffy” areola has persisted for 4 years, despite your successful weight loss, it is probable that you are dealing with gynecomastia. Best to verify this during in person consultation with board-certified plastic surgeons. It certainly won't hurt to wait on having surgical treatment;  unfortunately,  there is no specific diet or workout regimen that will necessarily improve the situation. Often, surgical treatment involves partial excision of the excess breast tissue;  sometimes,  peripheral liposuctioning is helpful as well. You may find the attached link helpful to you as you learn more about surgical options. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 756 reviews

Pufffy Nipples

+1
The term ‘puffy nipples’ refers to pure glandular gynecomastia, which describes cases of male breast enlargement that are due to an increase in the volume of fibrous breast tissue behind the nipple-areola complex, without any proliferation of excess fat in the surrounding area. This form of gynecomastia occurs almost exclusively in adolescent and young adult males. It may occur on just one side or on both, and if present on both sides it is often asymmetrical in volume.
All boys and men have a small mass of fibrous breast tissue immediately below the areolas. This small mass of breast tissue does not become apparent externally unless it grows in size to a point where the nipple-areola complexes begin to bulge outward, hence the term ‘puffy nipples’.
Treatment consists of excision of the excess breast tissue using one or more of a number of techniques: direct excision via an incision along the inferior border of the areola, ‘pull-through’ excision through two or more mini-incisions at the areolar border, and arthroscopy shaver excision via a remote mini-incision (ideally concealed in hair-bearing skin in the underarm area). As there is no fat excess in patients with pure glandular gynecomastia, no liposuction is required.
Care must be taken on the part of the surgeon to perform a precise excision of the excess breast tissue, and to preserve a thin cuff of breast tissue on the posterior surface of the areolas(s). Over-resection will result in areolar retraction and concavity as well as contour irregularity in the area immediately surrounding the nipple-areola complexes. Under-resection will result in the need for a second surgery to remove the remaining breast tissue. So it truly requires an experienced surgeon to accomplish that ‘just right’ excision that will produce a natural-appearing and aesthetically ideal result in these patients.
Make sure that you seek treatment from a board-certified plastic surgeon who can show you a number of ‘before and after’ photos – with results that appeal to you - for patients whom they have treated for pure glandular gynecomastia.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 41 reviews

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Gynecomastia Solutions

+1
It's unlikely weight loss and working out will reduce your "puffy nipples". From the photographs it looks like you have gynecomastia (male breasts). Gynecomastia is often an inherited condition that can not be improved without surgery. Fortunately, today there are improved techniques that reduce the size if your breasts and give you an improved appearance to your chest. Small incision surgery with a liposuction approach can safely and effectively help without the need for general anesthesia. Seek examination from a board certified plastic surgeon familiar with these improved approaches to discuss the best options for you.

Michelle Copeland, MD, DMD
New York Plastic Surgeon
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Treatment for Gynecomastia

+1
Hello and thank you for your question.
It appears as though you have a mild case of Gynecomastia. This can be easily treated with liposuction with or without some excision of glandular tissue.I recommend that you see a board certified plastic surgeon in consultation to get more specific answers to your questions which can best be addressed after a thorough history and examination is performed.
Best of Luck to you!

David Cangello, MD
New York Plastic Surgeon
5.0 out of 5 stars 7 reviews

Gynecomastia--Male Gland Enlargement is Likely: Physician Exam Will Confirm and Offer Alternatives

+1
The regular workouts and clean diet will enhance your general health, and may give small changes in the chest appearance, but the puffiness (conical projection) of the areola and nipples is probably not going away. 

Your plastic surgeon could feel the texture of the skin, normal body fat and any underlying fibrous or glandular tissue.  Based on that he or she could recommend whether surgery would be beneficial for you.  Dense material usually needs excision through a small incision hidden around the lower areola, while softer fatty material may be removed by liposuction through even smaller incisions.  Improved definition of the lower pectoral muscle border is likely.  Your chosen surgeon may have website photos showing possible results.  Best wishes. 

Sutton Graham II, MD
Greenville Plastic Surgeon
4.5 out of 5 stars 2 reviews

Gynecomastia Diagnosis

+1
The physical examination is the main goal to diagnosis Gynecomastia. This is a deformity that working out or diet won't resolve. Sometimes we can find a solution to this problem through a Liposuction. Othertimes wil need to resect the Gland tissue through an small or bigger incision. You must schedule a consultation with an ASAPS member plastic surgeon in your area. 

Luis Lopez Tallaj, MD
Dominican Republic Plastic Surgeon

Treatment of Puffy Nipples and Gynecomastia

+1
Thank you for your question and photos. If the puffiness you have noticed beneath yournipples has persisted over the later years of puberty and has not gone away with your weight loss, there is a good chance the enlargement of the male breast is there to stay. Male breast enlargement is called  gynecomastia. You will be able to control body fat with your diet and exercise, but not breast tissue. The growth of glandular breast tissue will not be reduced with foods thought to increase testosterone. The surgical removal of this tissue requires only a small incision around your areaola,  (the pigmented circle). The parts that make the puffiness can be removed with a combination of excision and liposuction. I hope this was helpful.

Mary Lee Peters, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 93 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.