Plastic Surgery for Pointy, Puffy Nipples in Men - Possible?

I don't have a big saggy breast but I have pointy puffy nipples, they only take a normal shape when I'm swimming in cold water or when I'm cold. Does it require a complicated surgery? Can it be done under local or general anesthethia? and is it pricey? Thank you

Doctor Answers 7

Nipple reduction in males is a procedure that can be done in the office under local anesthesia

There are three classes of male breast tissue development, or gynecomastia, ranging from Grade I (mild) to Grade III (severe).

Grade I gynecomastia in fact only involves the nipple and areolar complex.  Often a firm "button" of excess tissue can be felt beneath the nipple and areola, without other features of more significant breast tissue development.

If the presence of this tissue is bothersome, it can be removed surgically.  Liposuction alone of this area is ineffective as the tissue is dense and is actually breast tissue, rather than just fat alone.  Surgery involves making a semi-circular incision around the under-surface of the areola, at the junction of the colored circle and the chest. 

Excess tissue is removed, and the area is sutured using hidden, dissolving absorbable sutures.  Because this is a small area, it can be performed in a Plastic Surgeon's office operating room under local anesthesia

Be sure to visit a Board Certified Plastic Surgeon with experience in all types of breast procedures, including male gynecomastia.  Ask to see before and after photos, and to speak to other patients, if possible, who have had the procedure.

Karen M. Horton, M.D., M.Sc., F.R.C.S.C.

San Francisco Plastic Surgeon
3.5 out of 5 stars 10 reviews

You likely have a mild form of gynecomastia: usually simple to treat

Breast tissue development  in males (gynecomastia) is not uncommon, most often occurring at puberty. In some circumstance breast development in males can be due to other disease processes. A consultation with your plastic surgeon should rule that possibility out. In the vast majority of males, the breast tissue development is not associated with disease, and goes away with time. Unfortunately some patients have residual breast tissue, which makes them feel awkward or embarrassed in certain situations.

Gynecomastia can take many forms. What you describe sounds like a mild form of gynecomastia. Generally, there is a small mound or disc or breast tissue right underneath the areola. The skin may take on a pointed or puffed out appearance. The treatment is to remove the breast tissue and/or the excess skin. This can be done under local anesthetic. If just the breast tissue is removed, there will be an incision along the edge of the areola from approximately 4 to 8 o'clock. If excess skin needs removal, the incision will be carried along the entire perimeter of the areola, and the areola can be made smaller in diameter (if desired). Since the incisions are on the edge of darker and light her skin, they usually heal quite well.

This is not a 'pricey' nor a complicated procedure.

Best Regards.

Lawrence Tong, MD
Toronto Plastic Surgeon
4.7 out of 5 stars 45 reviews

Puffy Nipple Areola Complex

"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.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Surgery for "puffy" nipples

How do you tell whether the problem is excessive breast tissue (gynecomastia) vs. excessive nipple size?
If you have gynecomastia (enlargement of the male breast), the problem will get better when your nipples are cold (as you described).  Why?  Contraction of the nipple-areola will "push back" on the protruding breast tissues.  If you have excessive nipple size, the problem will actually get worse when your nipples get cold.  Why?  They'll stick out even more.

Why is this distinction important?  The treatments are completely different.  For excessive breast tissue, a "real" surgical procedure is required to remove the excessive tissue through a small incision at the junction of the pigmented and non-pigmented skin of the breast.  For excessive nipple size, a "minor" surgical procedure involves "clipping off" the excess tissue.  This is a much simpler procedure with a smaller recovery (and cost).  

Ronald Friedman, MD
Plano Plastic Surgeon
5.0 out of 5 stars 49 reviews

Office Correction of Puffy Nipples

Puffy nipples can be reduced by removing extra breast tissue directly below the areola and nipple. It is oftne done under local anesthesia as an office procedure. Addtional breast tissue fullness outside of the nipple area is usally removed with liposuction.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews


Thank you for the question.

Gynecomastia comes from the Greek meaning "gyne" meaning woman and  "mastos"  meaning breasts.  It refers to abnormal development of large mammary glands in males.  The diagnosis can be made by physical examination where relatively firm tissue  (breast gland tissue) can be differentiated from relatively soft tissue (adipose tissue).

Breast prominence due to excessive adipose tissue is called pseudo-gynecomastia or lipomastia.  The differentiation of true  gynecomastia  from adipose tissue is important because the surgical treatment may differ. Usually  physical examination by a well experienced board-certified plastic surgeon is sufficient to make the diagnosis  and to determine the best course of treatment.

I have found that gynecomastia 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, then liposculpture surgery alone may suffice.

I would strongly suggest that you make sure you are working with a well experienced board-certified plastic surgeon. You will find that this recommendation will be more important than any specific “miracle technology” that you will undoubtedly hear about.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Puffy nipples on men

Everyone has some breast tissue development to varying degrees.  The rudimentary breast development in men can present as "puffy nipples" and this is easily corrected by resecting the breast tissue behind the nipple and areola.  The cost is reduced from the usual "gynecomastia" correction because the technical requirement is shorter, simpler, and more straightforward. 

Randy Wong, MD
Honolulu Plastic Surgeon
4.8 out of 5 stars 36 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.