22 Year old male with puffy protruding nipples, What is the best procedure for me to get done? (photos)

I have looked up a lot about gynecomastia surgery and the various forms that can be done (chest liposuction/gland removal/nipples correction), and the ways excision is done (Half donut, donut, anchor). I need advice on what procedure would be most recommended to yield the best results; A defined looking chest. If not that, then just a chest that doesn't have a cone like appearance through clothing. Anything to make it look more normal, so I can return to walking around without slouching. Thank you

Doctor Answers 10

Treating Puffy Nipples

"Puffy Nipple Areola Complex" is among the most common forms of gynecomastia. This gland and/or adipose tissue accumulation can be located under the areola or can be slightly extended outside the areola, causing the areola to appear dome shaped.This form of #Gynecomastia can be found in all age groups but is more common in young adults.Men who suffer from large #areolas may notice that after breast surgery, the skin of the chest muscles will tighten, causing the areolas to tighten and diminish in size. This is a result of the removal of glandular and/or adipose tissue.

As each case is different, it is vital that you consult with a board certified plastic surgeon who is experienced in male breast surgery. The surgeon should determine if you are a suitable candidate for male breast reduction by liposuction or glandular excision. It is also crucial to have a plastic surgeon who is well-versed in the gynecomastia condition can determine if there is firm breast tissue beneath the areola that is causing the nipples to project (which is often the case), and if so, how much of this glandular tissue can be removed to create a flat appearance.
#PuffyNipple surgery generally takes only an hour or two, and the recovery time is short; sometimes less than a week. There is minimal scarring and the success rate is excellent. Therefore, patients who suffer from "Puffy Nipples", and who view it as an unaesthetic and unpleasant condition, may desire surgical intervention to correct the "puffy nipple" condition. 

Orange County Plastic Surgeon
5.0 out of 5 stars 110 reviews

22 Year old male with puffy protruding nipples, What is the best procedure for me to get done?

You can have a very nice improvement with surgery with a minimal incision approach.

Kenneth Hughes, MD

Beverly Hills, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Gynecomastia surgery

It is always difficult to give precise advice from photographs, but it seems that you would do very well with and incision around about one half of the areola to allow access for removal of your extra tissue. In your case, your skin may be capable of tightening to allow a nice flat contour with this minimal incision. Only a close examination by a board-certified plastic surgeon would be able to confirm this.

Ira H. Rex lll, MD
Fall River Plastic Surgeon
4.6 out of 5 stars 46 reviews



Thank you for your question.  An in-person exam with a board certified Plastic Surgeon will be the best way to find out which surgical plan is most appropriate for you. You should be able to achieve good results with some combination of excision and liposuction- through a small incision.

An excess growth of breast tissue and herniated/puffy areolas cannot be reduced with weight/fat loss. Gynecomastia affects all shapes and sizes of men- slim ones as well. The surgical techniques used to address this can be quite simple and relatively minor but you will need a customised approach. 

I recommend that you book your in-person consultation with a Plastic Surgeon who specialises in this procedure and find out about your options. Compare recommendations by meeting with more than one surgeon so that you feel confident with your plan.

All the best

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 179 reviews

Gynecomastia Surgery

Hi ktax1993,
Thanks for the post and photos. It appears that you have gynecomastia based on the photos. That being said the only way to give you advice about the specific technique best for you would be an in-person examination. This is not a cookie-cutter surgery and needs to be individualized. You will likely need excision but may or may not need liposuction.

Dr. Dadvand

Babak Dadvand, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 46 reviews


Most of the time I do these with a combination of glandular excision and liposuction. I think this would work well for you. Find a board certified plastic surgeon and get a consultation. You will get better advice from someone who has actually examined you.

Tracy E. McCall, MD
Milwaukee Plastic Surgeon
5.0 out of 5 stars 1 review


Thank you for the question and photos and though an examination is needed , you would probably benefit from an excision of the gland and fat via a small periareola incision.  So see some experts and become informed.

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 61 reviews


Patients with gynecomastia require removal of the glandular tissue and fat in the breast. The removal i accomplished through very small incisions (1.5 mm ) in the axilla and a small incision around the base of the areola.

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.6 out of 5 stars 14 reviews


Your pictures show a fairly common variety of gynecomastia. It's probably a combination of the gland and fat but no one will know for sure in advance. You have to be prepared to treat both.
this can be done through a tiny incision in the armpit with no visible scar on the front of your chest using both liposuction  and special instrumentation to remove the hard gland. As you are getting your consultations with board-certified plastic surgeon's find someone that utilizes this particular technique. Good luck on your treatment.

Sherwood Baxt, MD
Paramus Plastic Surgeon
3.8 out of 5 stars 25 reviews

22 Year old male with puffy protruding nipples, What is the best procedure for me to get done?

Thank you for the question and pictures. Accurate diagnosis would necessitate physical examination. It IS important to differentiate gynecomastia ( excess breast tissue) from lipomastia ( otherwise known as pseudo-gynecomastia or excess adipose tissue of chest wall). Treatment will differ depending on diagnosis. In most cases, gynecomastia is treated with resection of the excess breast tissue; peripheral chest liposuction may also be helpful.
 If your chest wall is still of concern, seek consultation with board-certified plastic surgeons who can demonstrate significant experience achieving the types of outcomes you will be pleased with.
You may find the attached link helpful to you as you learn more. Best

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 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.