What can I do about my puffy nipples? (Photo)

"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 consultwith a board certified plastic surgeon who is experienced in male breast surgery. A board-certified plastic 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.

You have true and pseudo gynecomastia.  Yours is a very specific problem requiring a 2-step very specific surgery.The first step requires a circumareolar nipple reduction leaving a small superior pedicle. The key element of this step is major gland removal and anchoring the dermis downward to the remnant of breast gland tissue.  This tightens the dermis and gets rid of the pouty nipple, then the outer and inner circles of nipple tissue are sutured together, preferably with a permanent suture around the outside.  This is known as the round block technique.  Allow 6 months to pass before the second step.The second step is an aggressive liposuction done from the lateral side of each breast.  This will get rid of some gland and all of the fat.  You are very fortunate.  Philadelphia is reef with outstanding plastic surgeons who have experience in this type of modified Benelli surgery. 

I am sorry to hear about your concerns regarding breast size/shape. Generally speaking, assuming a young man has achieved a long-term stable weight and there are no “causative agents” involved, surgery may be indicated to treat persistent gynecomastia. It is often best treated with partial excision of the prominent glandular tissue as well as liposuction surgery of the peripheral chest area. If the prominence of the chest wall is caused by adipose tissue alone , then liposuction surgery may suffice. When the time is right, seek consultation with well experienced plastic surgeons who can demonstrate significant experience achieving the types of outcomes you would be pleased with. You may find the attached link helpful to you as you learn more. Best wishes.