It is not unusual for young males to have puffy nipples. This may or may not go away on it's own. For younger teens, I suggest waiting at least a year before considering surgery unless the issue is very significant. A physical examination can determine whether or not the unwanted fullness is fat or glandular tissue. Either way, this can be improved by surgery. Visit a plastic surgeon with a lot of experience with gynecomastia. The goal will be to minimize the unwanted fullness with as little visible scarring as possible So many gynecomastia patients have shared with me the self-consciousness, embarrassment, frustration and psychological stress that they have endured because of breast enlargement. Most never feel comfortable taking off their shirt at the beach or at the pool or wearing a snug-fitting shirt. If you have experienced any or all of these issues personally, I want to assure you that (1) you are not alone and (2) essentially every case of gynecomastia can be significantly improved, and most can be corrected completely. The most common form of gynecomastia (‘mixed glandular/adipose’) requires ultrasonic liposuction and, in some cases, direct breast tissue excision as well. My goal is to create the smallest incision with the smallest scar possible. My library of gynecomastia videos will help explain the different approaches I take to addressing different types of gynecomastia. Take your time researching your surgeon. Look at several websites, go on several consultations, speak to other patients and of course view many many before and after photographs. Find a plastic surgeon who performs gynecomastia surgery often and with whom you feel comfortable.