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 (13)

Gynecomastia male breast reduction

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 41 reviews

You are describing a very mild form of gynecomastia


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 4 reviews

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Puffy Areolas and Nipples can be Improved

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 14 reviews

Puffy Nipples Can Occur With or Without Gynecomastia


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.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 78 reviews

Puffy nipples in men.


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 44 reviews

Gynecomastia Treatment


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 4 reviews

Puffy nipples and gynecomastia


puffy nipples are a very common problem with stimulated or excess breast tissue in guys.  All guys have breast tissue under the nipple.  You probably will get the nipples to settle down if you remove the breasts tissue even if it is small.

Jeffrey Ditesheim, MD, FACS
Charlotte Plastic Surgeon
4.5 out of 5 stars 12 reviews

Puffy nipples represent true Gynecomastia.


The fullness and protuberance that makes a dome effect of the nipple areola is due to the dense  breast tissue underneath the nipple areola area.The breast bud can grow to various degrees of size in the teenage years. The “Puffy Nipple Syndrome” is seen more in younger males than older men. The reason that it causes the cone shape of the nipple areola complex is because the fatty tissue around this area is not extensive but the lack of fat in the region makes the gland protrude even more causing puffy nipples.

Many times this condition will resolve on its own after puberty,  if it doesn’t, the treatment of the nipples is the same as true gynecomastia, it requires glandular excision. This removes the fullness and allows the nipple areola to shrink and flatten.




Miguel Delgado, Jr., MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 30 reviews

Puffy Nipples


Sounds like you may have been given good advice. For minimal puffiness (or excess tissue) surgery may cause more harm than help. In other words you need to weight the risk/benfit ratio to dtermine whether surgery and its resulting scar/risks are indicated. Good luck.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 727 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.