How can I flatten puffy nipples caused by tubular breast tissue without changing breast size? (photos)

Reducing the size of the nipple is a very simple procedure that is done in local anesthesia. For the most part, it includes wedge like removal of nipple, with preservation of most of milk ducts. Reduction of the larger areola and correction of tuberosity can be done in the same time without augmentation but is more complex procedure and varies depending of the type of deformity. In person consultation with someone familiar with this procedure is recommended. Good luck.

The technique I recommend is a circumareola lift. The excess skin is excised and places tension on the nipple-areola complex that will flatten it. Also, you are asymmetrical in volume and may benefit from fat transfers.

Best Wishes,

Gary Horndeski, M.D.

Dear Awesome464874,
tuberous breasts are not simply small or underdeveloped breasts. The appearance of the breast can range from mild to severe, and typical traits include: enlarged, puffy areola, rather wide spacing between the breasts, very little breast tissue, sagging, higher than normal inferior breast fold, and narrow base at the chest wall.The type of surgery best for you will depend on the severity of your condition.My preferred technique for tuberous breast correction involves a multistep procedure where the breast tissue is released in a radial pattern to prevent herniation into the areola and placement of a custom implant size is in the breast to allow appropriate expansion of the breast in the restricted dimensions. This can often be done in a single procedure but sometimes may require two surgeries.That said, it is best that you visit a board-certified plastic surgeon for an in person examination. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery