Puffy Nipples, Not Gynecomastia

I would suggest getting a second opinion from a board certified plastic surgeon that has interest and experience with treating gynecomastia. Even if it is a small amount it can be addressed.

Puffy nipples are caused by excess gland. sometimes it can be very small but it's still enough to push through the areola. Sometimes guys who think they only have puffy nipples are surprised to learn they actually have a bit more gynecomastia which extends outward. They are simply not aware of the difference. Regardless, surgery to correct te matter is a quick out patient proceudre with a very short recovery. it is important to choose an experienced gynecomastia surgeon because getting great results cn certainly be "harder than it looks". Good luck.

Gynecomastia is a spectrum and not a single condition. It is not unusual to get a puffy nipple which is called a grade 1. The solution is open excision and the scars tend to heal very well for this type of gynecomastia. Please see an experienced Plastic Surgeon who has a specialist interest in gynecomastia.

Thank you for your question.  I dedicate a large portion of my plastic surgery practice to the treatment of male chest concerns and gynecomastia.  From your description of "puffy nipples", it sounds like you may actually have some degree of gynecomastia.  My preference in treating many patients with "puffy nipples" is a minimal-incision approach that will remove the gynecomastic/"glandular" tissue thru a tiny "puncture" incision. Many patients have "something" they feel under the nipple as you describe.  This causes the nipple to be "puffy" and more protuberant. I recommend a small incision approach and removal of this tissue.  This allows the nipple to settle back naturally, shrink in diameter to some degree typically without full incisions around the areolae, and it allows the nipple to become flatter in an easy outpatient or even office-based procedure.  I hope this is helpful.  Good luck!

Examination is essential to determine how effective surgery will be for your concerns. Reducing the mound of tissue behind the areolae is the most effective and commonly offered treatment. In some patients, liposuction ( I prefer laser assisted liposuction but ultrasound assisted is also worthwhile) can help but not eliminate the problem. More often excision is combined with liposuction for best results. There are some patient who have minimal tissue behind their areolae but have larger diameter areolae that can be reduced with surgery. Non-surgical options have not yet been of any help.Surgery of the male breast should be straight forward to be done as an outpatient with a return to light activities in 1-2 weeks.