Confused about gynecomastia. Can puffy nipples just be fat? There was no gland after doing lipo and periareolar incision (Photo)

Question

My puffy nipples had been bothering me for years. During examination, surgeon said he was going to do tumescent liposuction and gland removal via periareolar incision. After surgery, he said there was no gland palpable after doing lipo. The chest looked flat already. He wanted to make sure and visually checked both nipples by doing the incisions. He said no gland was there. Could the puffy nipples be caused by just fat or did he miss the glands? Nipples are still puffy but not as much as preop.

Jed H. Horowitz, MD, FACS · Answer

"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.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. 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.

Tim Neavin, MD · Answer

How long are you after surgery? Swellings lasts for months, so don't sweat it yet.  I almost always perform glandular excision because lipo doesn't suck out breast.  However, it is possible that you had very little to no breast.  Things continue to improve over time after this operation.  Skin tightens, swelling goes down, and men are very, very happy.  As you will be. Congrats on your decisionon to go through with it!

Alejandro Nogueira, MD · Answer

Gynecomastia is, literally, "breast GLAND presence in a male"! there is nothing to think, detect/miss, it is always a glandular problem with a larger or smaller fatty component, liposuction is NOT the treatment of gynecomastia vera.

Karthik Ram, MRCS, DNB · Answer

Aren't  you one confused soul,So many questions in such a short time.Give yourself some more time. Results after liposuction and gland excision typically takes 3 to 6 months to stabilize. It looks good for the first 3 or 4 dys and then the swelling sets in.it gets bigger , by 10 days it might be as big as how it was before your surgery(especially in people with smaller sized chests). Slowly the swelling reduces over the next couple of months.Gynaecomastia correction is purely done for getting a good shape of the chest. the fat and the gland are removed to get a proper shape. leaving a little bit behind if a good shape is attained will not do you any harm. but retained fat and gland will cause the swelling to go down very slowly.keep visiting your surgeon regularly.if at all a revision is required , it is usually a minor office procedure.

Babak Dadvand, MD · Answer

Thank you for your post.  As previously mentioned, the fact that your nipples are still puffy may be due to post operative swelling. Although patients see improvements right after surgery, final results typically take up to six months to realize. Certainly fatty tissue can cause the nipples to be puffy and the treatment would be liposuction. However, if the cause of the puffiness is glandular tissue, then excision, and not liposuction would be the treatment.  As the saying goes, time will tell.Dr. Dadvand

Darryl J. Blinski, MD · Answer

Something does not add up! If incisions were made than removal of fat/tissue should have been done. Plus any tissue excised should have a pathologic review. Best to seek in person paid second opinions.

Barry L. Eppley, MD, DMD · Answer

If you have persistently puffy nipples after all the swelling has gone down from the surgery (4 to 6 months postop), then there is residual gland tissue that could be removed for a flatter result.

Steven Wallach, MD · Answer

If you recently had surgery, then puffy nipples are quite common and this could last for 4-6 months. Best to give it time to heal.

Charles A. Wallace, MD · Answer

If you are having puffiness in the nipple area after surgery, it could be that you haven't allowed enough timefor healing.  Allow at least 2-3 months for healing and swelling.

Mordcai Blau, MD · Answer

You have to wait until the swelling around the areola will subside to see the real results,and if you have residual gland ,since the gland was not removed.In my practice for all patients that are not obese we remove the gland.Wait and see.Be patient.

Confused about gynecomastia. Can puffy nipples just be fat? There was no gland after doing lipo and periareolar incision (Photo)

Answers (13)

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