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 (16)

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 45 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 6 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 55 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!

Puffy Areolas and Nipples can be Improved

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Many of the answers below refer to enlarged diameter of the areola, which doesn't seem to be your concern. If you have little fat but a small "lump" behind the nipple and areola that causes them to protrude, this can usually be addressed with a small incision along the lower border of the areola, with excision (removal) of the lump. The scar generally becomes quite inconspicuous with time. Aggressive liposuction can produce excellent results in many cases, but this depends on the density of the tissue behind your nipple and areola. If it's very hard and tough, then it would be best to excise it rather than suctioning.

Andres Taleisnik, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 16 reviews

Puffy Nipples Can Occur With or Without Gynecomastia

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The presence of puffy nipples in men can occur with or without gynecomastia. In the majority of patients, they are associated with gynecomastia but rarely they are an isolated finding. Many patients with puffy nipples are extremely bothered by their appearance because they tend to make the chest look feminine. For this reason, men frequently seek treatment of this condition.

Treatment usually requires a peri-areolar mastoplexy with reduction in areola size. The incision is placed between the pigmented areola and normal skin where the incision is minimally visible. Through this incision, excess areola can be removed. When gynecomastia is present, this can also be addressed through the same peri-areolar incision.

It’s important to consider the risk benefit ratio before proceeding with correction of this condition because treatment will involve trading puffy nipples for a scar around the border of areola.

Consultation with a board-certified plastic surgeon should be considered in any patient with this problem.

Puffy nipples in men.

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Puffy nipples can occur with gynecomastia or they can occur independent of excess fat and gland in the breast.  The treatment for puffy nipples is a procedure where the excess areola (the pigmented skin around the actual nipple) is removed via an incision around the areola and the remaining areola is stretched out so it is flat.  If the nipple is overly prominent, it can be reduced at the same time.  Also, if there is excess fat and/or gland, that can also be taken care of.  This reduction in the areola leaves a scar around the areola.  That scar usually fades with time and blends into the normal pigment of the areolar/skin margin. 

Lisa L. Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 49 reviews

Gynecomastia Treatment

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In men, puffy nipples are one of the hallmarks of gynecomastia. If you notice the appearance of the glandular tissue, and it is more pronounced when flexing the muscles below even if the effect is very subtle, you are more than likely a candidate for gynecomastia treatment. Since the problem is glandular tissue rather than fat cells (which could be removed through liposuction), then surgery would be needed. From what you are describing, the level of correction should be very minimal. Nipple size can be reduced at the same time, if you’re unhappy with the appearance of the nipples. More importantly, if you are self-conscious about the appearance of the puffiness, definitely see another surgeon for a second opinion.

David N. Sayah, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 5 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.