Puffy Nipples, Not Gynecomastia

Thank you for your question and congratulations on seeking a consultation.  While your case seems to be on the milder end of the spectrum, your puffy nipple symptoms are certainly a sign of gynecomastia.  While it is normal for all men to have some glandular tissue, if you are very lean even a small amount of glandular tissue can lead to a puffy nipple areolar complex and the negative consequences that you are experiencing.  The good news is that Gynecomastia surgery can treat this problem with virtually no scars.  Removal of the glandular tissue will cause the areola to shrink in size and the nipple to lay more flat.  Consider seeking another consultation with a surgeon with extensive experience in gynecomastia surgery.  I hope this helps!  All the best!

Hi @EuroFine, Thanks for the question!
For these puffy nipples,  patients typically will have a rubbery, more firm glandular component which tends to be centralized under the nipple area. For these patients, I recommend the Pull Through Technique along with very little liposuction. This involves a tiny incision away from the breast, concealed in an area of natural shadow, and through that incision we first liposuction all the fatty tissue and then use that same incision to remove the rubbery glandular tissue from behind the nipple. The scars are imperceptible and heals great. 
This procedure has a shockingly high success rate at creating a masculine and flat chest surface that won't show through sweaters or shirts which is usually the main complaint I hear from patients with gynecomastia.
Thanks,
Dr. Karan Chopra
Plastic & Reconstructive Surgeon
Johns Hopkins Trained 
Body & Face Expert

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.