I don't have a big saggy breast but I have pointy puffy nipples, they only take a normal shape when I'm swimming in cold water or when I'm cold. Does it require a complicated surgery? Can it be done under local or general anesthethia? and is it pricey? Thank you
Plastic Surgery for Pointy, Puffy Nipples in Men - Possible?
Doctor Answers 6
Nipple reduction in males is a procedure that can be done in the office under local anesthesia
There are three classes of male breast tissue development, or gynecomastia, ranging from Grade I (mild) to Grade III (severe).
Grade I gynecomastia in fact only involves the nipple and areolar complex. Often a firm "button" of excess tissue can be felt beneath the nipple and areola, without other features of more significant breast tissue development.
If the presence of this tissue is bothersome, it can be removed surgically. Liposuction alone of this area is ineffective as the tissue is dense and is actually breast tissue, rather than just fat alone. Surgery involves making a semi-circular incision around the under-surface of the areola, at the junction of the colored circle and the chest.
Excess tissue is removed, and the area is sutured using hidden, dissolving absorbable sutures. Because this is a small area, it can be performed in a Plastic Surgeon's office operating room under local anesthesia.
Be sure to visit a Board Certified Plastic Surgeon with experience in all types of breast procedures, including male gynecomastia. Ask to see before and after photos, and to speak to other patients, if possible, who have had the procedure.
Karen M. Horton, M.D., M.Sc., F.R.C.S.C.
You likely have a mild form of gynecomastia: usually simple to treat
Breast tissue development in males (gynecomastia) is not uncommon, most often occurring at puberty. In some circumstance breast development in males can be due to other disease processes. A consultation with your plastic surgeon should rule that possibility out. In the vast majority of males, the breast tissue development is not associated with disease, and goes away with time. Unfortunately some patients have residual breast tissue, which makes them feel awkward or embarrassed in certain situations.
Gynecomastia can take many forms. What you describe sounds like a mild form of gynecomastia. Generally, there is a small mound or disc or breast tissue right underneath the areola. The skin may take on a pointed or puffed out appearance. The treatment is to remove the breast tissue and/or the excess skin. This can be done under local anesthetic. If just the breast tissue is removed, there will be an incision along the edge of the areola from approximately 4 to 8 o'clock. If excess skin needs removal, the incision will be carried along the entire perimeter of the areola, and the areola can be made smaller in diameter (if desired). Since the incisions are on the edge of darker and light her skin, they usually heal quite well.
This is not a 'pricey' nor a complicated procedure.
Surgery for "puffy" nipples
If you have gynecomastia (enlargement of the male breast), the problem will get better when your nipples are cold (as you described). Why? Contraction of the nipple-areola will "push back" on the protruding breast tissues. If you have excessive nipple size, the problem will actually get worse when your nipples get cold. Why? They'll stick out even more.
Why is this distinction important? The treatments are completely different. For excessive breast tissue, a "real" surgical procedure is required to remove the excessive tissue through a small incision at the junction of the pigmented and non-pigmented skin of the breast. For excessive nipple size, a "minor" surgical procedure involves "clipping off" the excess tissue. This is a much simpler procedure with a smaller recovery (and cost).
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Office Correction of Puffy Nipples
Thank you for the question.
Gynecomastia comes from the Greek meaning "gyne" meaning woman and "mastos" meaning breasts. It refers to abnormal development of large mammary glands in males. The diagnosis can be made by physical examination where relatively firm tissue (breast gland tissue) can be differentiated from relatively soft tissue (adipose tissue).
Breast prominence due to excessive adipose tissue is called pseudo-gynecomastia or lipomastia. The differentiation of true gynecomastia from adipose tissue is important because the surgical treatment may differ. Usually physical examination by a well experienced board-certified plastic surgeon is sufficient to make the diagnosis and to determine the best course of treatment.
I have found that gynecomastia is often best treated with partial excision of the prominent glandular tissue as well as liposuction surgery of the peripheral chest area. If the prominence of the chest wall is caused by adipose tissue, then liposculpture surgery alone may suffice.
I would strongly suggest that you make sure you are working with a well experienced board-certified plastic surgeon. You will find that this recommendation will be more important than any specific “miracle technology” that you will undoubtedly hear about.
I hope this helps.
Puffy nipples on men
Everyone has some breast tissue development to varying degrees. The rudimentary breast development in men can present as "puffy nipples" and this is easily corrected by resecting the breast tissue behind the nipple and areola. The cost is reduced from the usual "gynecomastia" correction because the technical requirement is shorter, simpler, and more straightforward.