Puffy Nipples, Not Gynecomastia

Many of the answers below refer to enlarged diameter of the areola, which doesn't seem to be your concern. If you have little fat but a small "lump" behind the nipple and areola that causes them to protrude, this can usually be addressed with a small incision along the lower border of the areola, with excision (removal) of the lump. The scar generally becomes quite inconspicuous with time. Aggressive liposuction can produce excellent results in many cases, but this depends on the density of the tissue behind your nipple and areola. If it's very hard and tough, then it would be best to excise it rather than suctioning.

I would suggest getting a second opinion from a board certified plastic surgeon that has interest and experience with treating gynecomastia. Even if it is a small amount it can be addressed.

Puffy nipples are caused by excess gland. sometimes it can be very small but it's still enough to push through the areola. Sometimes guys who think they only have puffy nipples are surprised to learn they actually have a bit more gynecomastia which extends outward. They are simply not aware of the difference. Regardless, surgery to correct te matter is a quick out patient proceudre with a very short recovery. it is important to choose an experienced gynecomastia surgeon because getting great results cn certainly be "harder than it looks". Good luck.

Gynecomastia is a spectrum and not a single condition. It is not unusual to get a puffy nipple which is called a grade 1. The solution is open excision and the scars tend to heal very well for this type of gynecomastia. Please see an experienced Plastic Surgeon who has a specialist interest in gynecomastia.

Thank you for your question.  I dedicate a large portion of my plastic surgery practice to the treatment of male chest concerns and gynecomastia.  From your description of "puffy nipples", it sounds like you may actually have some degree of gynecomastia.  My preference in treating many patients with "puffy nipples" is a minimal-incision approach that will remove the gynecomastic/"glandular" tissue thru a tiny "puncture" incision. Many patients have "something" they feel under the nipple as you describe.  This causes the nipple to be "puffy" and more protuberant. I recommend a small incision approach and removal of this tissue.  This allows the nipple to settle back naturally, shrink in diameter to some degree typically without full incisions around the areolae, and it allows the nipple to become flatter in an easy outpatient or even office-based procedure.  I hope this is helpful.  Good luck!

Examination is essential to determine how effective surgery will be for your concerns. Reducing the mound of tissue behind the areolae is the most effective and commonly offered treatment. In some patients, liposuction ( I prefer laser assisted liposuction but ultrasound assisted is also worthwhile) can help but not eliminate the problem. More often excision is combined with liposuction for best results. There are some patient who have minimal tissue behind their areolae but have larger diameter areolae that can be reduced with surgery. Non-surgical options have not yet been of any help.Surgery of the male breast should be straight forward to be done as an outpatient with a return to light activities in 1-2 weeks. 

"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. The most important decision to be made before performing any surgical procedure is determining whether you are an ideal #candidate.

Puffy nipples is a common problem where patients do not require treatment for gynecomastia as a whole (liposuction  / liposuction with gland excision), but need to address just the puffiness. The puffy nipple results due to a larger diameter of the areola & a small glandular component below the nipple areola complex. Both need to be addressed for a successful outcome.The surgery is done under local anaesthesia as daycare. It would involve a circumferential excision of the areolar rim along with the glandular tissue though a small incision. I hope this helps.

Pictures would be helpful, but it sounds like you may have a mild form of gynecomastia. If the appearance is bothersome, a simple subareolar resection will recontour the tissues beneath the areola and masculinize your chest contour.  Sometimes liposuction will be used to feather out the resected area.  Consult in person with an experienced plastic surgeon.

You can have the excess tissue removed to make your nipples less puffy, but with any surgery you will be left with a minor scar. Please see a surgeon who is experienced in this.