27 in Massachusetts. i have a very mild form of gynecomastia (localized to nipples only). my nipples are soft and pillow like in appearance and to the touch. i have read surgeons saying that lipo is enough to treat mild gynecomastia, but others say no; that the glad has to be excised, and i also read that if to much is removed then you are left with an inverted nipple. so i am just wondering what the right approach is for someone with a mild case of gynecomastia.
Puffy Nipples: to Excise the Gland or Not Excise the Gland? (photo)
Doctor Answers (4)
Excision probably better
The surgery itself is short (only one or two hours) and often requires less than a week for recovery. Large areolae often become smaller after glandular and/or adipose tissue has been removed during the procedure as well. This side effect is the result of the skin covering the chest muscles tightening through the treatment process.
Puffy Nipples Can Easily Be Removed
Generally the tissue just beneath the nipple and areola is dense and is not able to be suctioned out well. I prefer to remove it through a small incision at the edge of the areola by a combination of avulsion and excision. It is not likely to cause inversion of your nipples.
Puffy Nipples and Gynecomastia
In minimal gynecomastia, where the problem is limited solely to prominence or puffiness immediately beneath the nipple, simple direct excision probably is the best option. The tissue in this area is usually dense glandular tissue and is difficult to remove with liposuction alone. Even liposuction that has an added energy source - ultrasound (VASERLIPO) or laser (SMARTLIPO) - may not adequately remove this dense tissue.
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“Puffy Nipples" Best Treatment?
Thank you for the question and pictures.
The best treatment for localized glandular tissue causing “puffy nipples” is direct excision; whether this operation will be indicated in your case depends on how much the prominence bothers you in comparison to how much an incision below the areola (resulting from surgery) will bother you. If the prominence caused by breast tissue, not adipose tissue, liposuction alone will likely not be effective.
Only you will be able to determine whether the trade-off of a scar is worth the improvement in contour. For example, will the presence of a scar below the areola prevent you from removing your shirt?
If you do decide to proceed with surgery make sure you have the procedure done by a well experienced board-certified plastic surgeon.