Puffy Nipples, Not Gynecomastia

i had a consult with a plastic surgeon yesterday and he said that the gland under my nipples is very small. And that evey man has a little bit of gland and its not gynecomastia. You cant feel it unless i contract my muscles. And its about the size of the peanut. But its still the cause for my puffy nipples, because i have no fat. So i dont know what to do. Isit still gynecomastia but just a very mild case. and i need to only have a very small amount removed. Ive had it for 6 years now.

Doctor Answers (20)

Gynecomastia male breast reduction

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Even with minimal breast tissue enlargement, an enlarged areolar diameter tends to produce a feminized breast/chest appearance. For patients with an enlarged areolar diameter, an areolar reduction can be performed in addition to direct excision of breast tissue and liposuction. This requires an incision, and thus a scar, that encompasses the entire circumference of the areola. However, the scar is usually obscured fairly well by the color difference between areolar skin and the adjacent chest skin, and the reduced areolar diameter can be critical to producing a more masculine appearance of the anterior chest.


Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 46 reviews

You are describing a very mild form of gynecomastia

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You are describing a very mild form of gyenecomastia.  When confined to the areaola, a reduction in the size of the areola and resection of the tissues just deep to its surface is usually sufficient to remedy the situation.

Chen Lee, MD
Montreal Plastic Surgeon
5.0 out of 5 stars 7 reviews

Puffy nipples (areola)

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What you describe is gynecomastia.  Feeling it is different than seeing it.  If it is visible, then it may make sense to have it surgically excised.  If it is just palpable, it may make sense to observe unless it really, really bothers you.  Procedure is rather easy and includes a well camouflaged incision around the areola.  Recovery is quick. 

Tim Neavin, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 6 reviews

Gynecomastia

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Gynecomastia is usually caused by a combination of excess fat and breast tissue.  In some patients with little body fat, it is the breast tissue causing the result.  Fat can be removed with specialized liposuction techniques ( that also help skin to contract), while the excess breast tissue needs to be excised through a small incision around the areola.
Hope that helps.

Joshua Korman, MD
Mountain View Plastic Surgeon
5.0 out of 5 stars 7 reviews

Gynecomastia can be large of small

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Even though your case may be mild, it sounds like it is bothersome to you. It is true that even men have breast tissue, but if it is palpable and annoying to you, (in my opinion) it is worth removing if its affecting your quality of life.

Gynecomastia and areolar size

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A photo would be helpful. Some patients with puffy nipples may undergo an areolar correction surgery to reduce the puffiness and size of the areola. 

Best, 

Dr. Karamanoukian 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 57 reviews

Puffy Nipple Correcive Measures

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Puffy nipples can be reduced by removing extra breast tissue directly below the areola and nipple. It is often done under local anesthesia as an office procedure. Addtional breast tissue fullness outside of the nipple area is usally removed with liposuction. Exercise will not help this condition. Cost depends on experience of the surgeon, location of the surgery, surgical time, and type of anesthesia used.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 59 reviews

Puffy nipples often a sign of Gynecomastia

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Prominent nipples, especially when accompanied by a nodule under the areola, is a localized form of gynecomastia. You most likely have a small breast bud which is best remedied with direct excision.  If you do not have a significant breast bud but still have prominent nipples you may benefit from a nipple reduction. Depending on your overall situation this procedure may be completed in an office operative setting under local anesthesia. Ask a board certified plastic surgeon with experience treating gynecomastia for a thorough evaluation.

Different Causes for Puffy Nipples

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Often, patients who slowly develop “diffuse” or fatty gynecomastia are not aware of it because it comes on so gradually.  It is easy to miss, especially if the patient is overweight and there is little or no subareolar mass.  Patients well developed pectoral muscles also can have significant gynecomastia that is assumed to be pectoralis muscle.  In both cases, the gynecomastia is not noticed, even though the underlying fullness causes an enlarged, “puffy” nipple areolar complex (the nipple and surrounding pigmented skin).
Another possible explanation is a condition called tuberous breast, which is more common in females, but can also affect men.  A tuberous breast will usually have an enlarged, “puffy” nipple areolar complex, often with thinned areolar skin which bulges outward, thus appearing puffy.  A tuberous nipple areolar complex can appear puffy with little or no underlying gynecomastia.
The appropriate treatment for your puffy nipples would depend on the specific diagnosis.  I would recommend that you see another surgeon in your area that is certified by the American Board of Plastic Surgery, who can sort things out for you.
I hope this is helpful.Good luck!

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.