Does tamoxifen work for decreasing puffy nipples?

Unfortunately one of the side effects of finasteride is estrogen production.  When the cause of gynecomastia cannot be identified, brief use of tamoxifen may be recommended to reduce breast enlargement in males. Males who have had gynecomastia for over a year typically do not benefit from taking the drug. 

Thank you for sharing your question.  Tamoxifen does work best for glandular hypertrophy and would most likely not address any excess adipose tissue.  Liposuction would offer the most reliable, permanent correction if diet and exercise fails to resolve the issue.