How Does Nipple Size Influence the Male Breast Reduction Technique Choice?

Are large nipples easier or more difficult to protect from complications or damage during a breast reduction surgery?

Doctor Answers 10

Male breast reduction - gynecomastia

Nipple size does not influence the technique necessary in order to perform male breast reduction.

There are 2 standard techniques for performing correction of gynecomastia.

In the first and oldest method an incision is made around the edge of the nipple. Through this incision breast tissue is removed directly. This leaves a half moon or smiley face scar around the lower edge of the areola.

There is a newer technique called the "pull through" method where are a small 3mm incision is placed out at the edge of the chest. Fat and glandular breast tissue is then removed through this tiny incision. This operation allows for the same amount of tissue to be removed but without the scar around the nipple.

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Does nipple size influence technique in gynecomastia surgery

The condition that you are describing is a classic typcial  gynecomastia.  It usually presents as a young adolescent male, possibly a little over weight.  As you mature in to your late teens early 20's and the weight comes down the breasts stay the same.  There is no non-surgical method to correct this problem.  Liposuction is occasionally helpful but if there is any breast tissue under the areola a subcutaneous mastecomy is required.  A full examination is needed to give you more information as to which treatment will be effective.  It does no good to try to liposuction breast tissue as it will not aspirate.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 11 reviews

Male breast reduction surgery technique

Dear patient, When you talk about the nipple size, I believe you are referring to the size of the areola (the colored skin around the nipple). The size of the areola has little to no bearing on this type of surgery. The predominant factors in determining what type of technique is used, is the amount of fat deposits and skin laxity that you have on your breasts. 


Teanoosh Zadeh, MD
Montreal Plastic Surgeon
5.0 out of 5 stars 5 reviews

Nipple size and gynecomastia surgery

The nipples do not influence the type of surgery done for gynecomastia. 

If you are actually asking about the areolas (the colored area around the nipple), it's a different story.  If a guy has large diameter areolas and wants them to be smaller, that can almost always be accomplished at the time of gynecomastia reduction.  Making the areolas smaller allows the surgeon to tighten the skin of the breast a little bit and that can be helpful in some cases.

If a guy has really, really big nipples, it's easy to do a nipple reduction at the same time as the gynecomastia.  I've done a few nipple reductions in guys with otherwise really normal breasts because they did not like "nipping out".  It's a quick procedure with a high rate of patient satisfaction.

Lisa L. Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 53 reviews

Breast Reduction, Surgery, Gynecomastia

The size of the nipple does not influence Breast Reduction Technique or increase/decrease complications of surgery.

Jeffrey S. Yager, MD
New York Plastic Surgeon
4.0 out of 5 stars 54 reviews


it has very little to do with the operation. my particular approach is the"Scarless" Using both liposuction And the microexcisional Tool for removal of the gland and with no cutting whatsoever around the areola. the entire procedure is performed through axilla so it is not related to the size of the areola.

Sherwood Baxt, MD
Paramus Plastic Surgeon
4.5 out of 5 stars 13 reviews

More difficult.

In my opinion, men who have gynecomastia with enlarged nipple-areola complex may have a problem with the contraction of this tissue after surgery.  The areola doesn't contract as well as normal skin, so i feel it can be more difficult.

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 39 reviews

Male breast reduction and nipple/areola size

The vast majority of male breast reductions don't need anything done specifically to the nipple or areola.  The procedure is completely different from a female breast reduction.  If there is an extreme amount of excess tissue and skin (like after massive weight loss), then skin will need to be removed, the areola (not the nipple) re-sized, and scars will result.  However, the position of the nipple/areola on the breast/chest must be planned properly, as it is different than a female configuration.

Male breast reduction

Nipple (actually, areolar) size is important in male breast reduction because the areola should be sized appropriately for your chest.  The reduction technique should take this into account to provide the best results.

Nipple Size do not Influence the Male Breast Reduction Technique Choice

Men Breast or Man Boob (Gynecomastia) correction surgery is a collection of surgical procedures which de-feminize a female appearing male breast. The choice of WHICH procedure is done would depend on the size and feature of the feminized male breast.

Moderate enlarged breasts which are made mostly of fat usually respond to liposuction or VASER liposuction. If there is a larger component of breast gland tissue it may have to be surgically removed. If the breasts are elongated and overhanging, a formal matectomy may be required to flatten the chest.

The height and caliber of the nipples and the diameter of the areolas will need to be considered and addressed separately. If the appearance of the nipples bothers you, discuss it with your Plastic surgeon and have him address it as part of YOUR customized gynecomastia correction strategy plan.

Good Luck.

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 69 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.