Male Puffy Nipples -- Fix Without Full Gyno Surgery?

Question

Hello I am a rather lean 32 year old male with puffy nipples. I would say I have Type 1 Gynocomastia. I was wondering if its possible to have my nipples fixed without the full blown gyno surgery. The shape of my pectoral/breast area isn't really an issue, as its mainly in my nipples. They are convex and puffy, and I'd love to get them flat. From what I understand, I still need a full blown gyno surgery, but I was wondering if there are other opinions out there.

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.

Kenneth Hughes, MD · Answer

Whether you have puffy nipples or puffy areolae, both can be corrected in a small procedure under local anesthesia.  Kenneth Hughes, MD Los Angeles, CA

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thank you for the question.  If the nipple/areola is the problem then directed excision is helpful or an in office local liposuction could be beneficial.  The first step would be to have a consult and exam with a BC PS.

	Dr. ES

Daryl K. Hoffman, MD · Answer

If your only manifestation of gynecomatia is puffy nipples, you don't need the full surgery.  Puffy male nipple can be fixed by minimal local surgery.  Direct excision, through the nipple is very effective.  Local anesthesia is the norm. Scars are minimal. It usually involves removing gland just behind the nipple. See photos of similar cases so you know that you and your surgeon are on the same page.

Karan Chopra, MD · Answer

Currently, there is no pill, cream or exercise that can get rid of male breast tissue as safely, and permanently as a surgical chest contouring surgery.
Man Boobs (aka Gynecomastia) affects up to 65% of men! I guess it’s one of those things we don’t talk about but there’s some really easy options to get this taken care of permanently. 
There are typically two types of surgically correctable gynecomastia. The first, is the result of excess fat accumulation in the chest. The second, is more excess breast glandular tissue and less of a fatty component. Oftentimes, it’s a combination of these two and there are some really great options to manage these.
If it’s mainly fat, we have a couple options the first is wide awake flash recovery liposuction which is very well tolerated, doesn’t require going to sleep (but you can if you want to) and the second is a non invasive option like CoolSculpting or CryoLipolysis which is freezing the fat cells.These are both great options for patients which primarily fatty gynecomastia or pseudogynecomastia. 
The other group of patients we typically see, which is the majority, will have some fat but also a rubbery, more firm glandular component which tends to be centralized under the nipple area. For these patients, I like to use the Pull Through Technique along with 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. 
Both of these options lead to 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

Michael Law, MD · Answer

Many men who are at an ideal wright and do not have excess fat around their chest area can still have puffy nipples. The puffiness is caused by glandular tissue behind the nipples. A minor surgical procedure can remove unwanted tissue behind the nipple and provide a man with the kind of look he is hoping for.Although this surgery sounds straightforward, it is important to find an experienced surgeon. The goal is for the contours to be smooth and ideally the scars will be barely perceptible.

Sean Doherty, MD, FACS · Answer

Thanks for your question. Unfortunately, the answer is most likely no--gynecomastia requires surgery. This is a full male chest caused by benign breast tissue.and/or excess fat as well. Every male has fat and breast tissue on their chest, but you may have a bit too much. This extra tissue could be causing your areola (not your nipple) to appear puffier and larger than you want them too. The good news is that all of these issues can be worked on with a fairly simple surgical procedure. The recommended procedure may be liposuction and/or surgery. You should expect 5-7 days of downtime and you will be wearing a compression garment for a few weeks after surgery. I suggest you see a Board Certified Plastic Surgeon for a consult and your best options.

David F. Pratt, MD · Answer

It sounds like you have a low BMI (Body Mass Index), therefore, you probably do not have a significant amount of fatty breast tissue causing your "puffy nipples", which you refer to as "Type 1 Gynecomastia", also known as purely glandular hypertrophy (overgrowth).  In patients such as yourself, I prefer to perform a “stealth excision”, in which I make a several
millimeter “stab” incision within the areolar skin, and then remove the
stubborn breast tissue with a clamp and scissors, resulting in a "deflated", normal appearing areola.  A dissolvable stitch or two is used to close
the tiny incision, leaving an imperceptible scar.    The key to this technique is to know when to stop removing breast tissue, in order to avoid an unnaturally "indented" nipple and areola.  Because I remove small amounts at a time, I am able to accurately remove just enough "gland" to completely treat the "puffy nipple", without causing an unnatural depression.What you refer to as "full blown gyno surgery" usually implies performing a traditional "en-block" excision of glandular tissue through a "periareolar" incision, which usually goes at least halfway around the areola, with or without liposuction.I hope you find this answer helpful.  Good luck!

Babak Dadvand, MD · Answer

Hi momo3333,Thanks for the post. True puffy nipples is due to excess glandular tissue located under the areola. This needs surgery to correct. There is no such thing as "full blown gyno surgery". There are different techniques that are utilized to treat each man's specific cause of excess tissue, whether it is fat removal, gland removal, skin removal, or all of the above. It seems that in your case, you would only need a small incision under the areola to remove the gland. I would recommend that you be seen by a plastic surgeon who specializes in gynecomastia surgery. Sincerely,Dr. Dadvand

Craig Mezrow, MS, MD, FACS · Answer

There are different degrees or variations of gynecomastia that can be improved with a variety of procedures. When the excess tissue is limited to only beneath nipple region; there are surgical techniques that can be employed to only address that region. It is recommended to be evaluated by a plastic surgeon who discuss your options.

Male Puffy Nipples -- Fix Without Full Gyno Surgery?

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