Results from Gynecomastia Surgery After 6 Months - Puffy Nipples?

I got surgery for ginecomastia (gland+lipo) 6 months ago. From a month after the surgery my nipples started to get puffy again. It has been 6 month after the surgery, my nipples are still puffy, the doctor is saying that until 12 months it will not be flat and that the scares inside are making them puffy. I can notice a lumb underneath both nepples, doc says that those are scares but I think they are gland. It is normal to have the nipples puffys after 6 months from surgery? Thanks.

Doctor Answers 13

Puffy nipples after Gynecomastia treatment

usually puffy nipples are either caused by excess breast gland under the nipple or by excess scar tissue. In either case, you might consider excising breast tissue through a very small incision through the areola.

Beverly Hills Plastic Surgeon
4.4 out of 5 stars 41 reviews

Post op concerns

Minimal gauze dressing is applied following the procedure and an easily concealed support elastic garment is usually worn to minimize swelling and help skin to contract for a 3-4 weeks following surgery. Sutures are typically removed within 7 to 10 days of surgery.
Patients engage in gentle activities of daily living for the first 10 days. No aerobic exercise for at least 3 weeks. Patients may take gentle walks after a few days.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 125 reviews

Puffy Nipples After Gynecomastia Surgery

Hi rff,

Thanks for the post. Typically six months is enough time for the healing process to have settled significantly.  The fact that your nipples began getting puffy again a month after surgery points more to the fact that it is likely scar tissue formation. If it were residual gland, they would have been puffy right after surgery. There are massage techniques and even kenalog injections that may help break up the scar tissue. If that does not work, then you may need a revision surgery.


Dr. Dadvand

Babak Dadvand, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 37 reviews

Lumps under areola

You may want to get a second opinion, or return to your surgeon to talk about your results. Massage may help but you'll most likely benefit from revision surgery.

See your plastic surgeon

During the healing and recovery process, there should be communication between you and your surgeon. If you are not happy, this should be communicated with your surgeon. Ask how and when revision surgery is performed. 

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 109 reviews

6 months should be enough time for the majority of swelling to have resolved

Under normal circumstances, 6 months should be enough time for the great majority of swelling to have resolved following gland excision and liposuction of gynecomastia. 

Possible reasons for persistent subareolar swelling would include under-resection of the glandular tissue, post-op bleeding into the subareolar “dead space” with subsequent thick scar formation, regrowth of the gynecomastia glandular tissue, or post-operative weight gain in the case of pseudo-gynecomastia.

Treatment of residual “puffy nipples” would depend on the exact cause.  Thick scar tissue can be treated with aggressive massage and/or corticosteroid injections directly into the scar tissue.

Under-resection of the gland or regrowth may require additional surgery to correct and possibly a thorough endocrine evaluation to rule out a continued stimulus for the growth of the breast tissue. 

Persistent or worsening fatty deposits in the breast area may be treated with additional liposuction, and post-operative weight gain should be addressed with a healthy diet and exercise.

I hope this answers your question.  Good luck!

Gynecomastia Surgery Results?

Thank you for the question.

It sounds like the correct operation was done to treat the gynecomastia.  The tissue you are feeling may be either scar tissue or residual breast gland.

You have to be careful not to remove too much tissue and end up with a contour deformity/depression.

Best wishes.

Puffy Nipples.will be better or not after 6 months?

 It is hard to answer this question accuretly without examinanig you.But generally in most,but not all cases,6 months is enough.In certain cases,that are coplex,large or saggy male breasts, it can take a year or more. Most of the swelling had subsided,but scares may remain and palpable for a longer period.All of this is true assuming the surgeon had excised the glandular tissue and removed enogh fatty tissue. I hope is has improved by now.

Mordcai Blau, MD
New York Plastic Surgeon
4.7 out of 5 stars 50 reviews

Persistent nipple puffiness after gynecomastia reduction

After 6 months, the residual puffiness of the nipples is not likely to improve. It is either the result of residual hard breast tissue that remains if only liposuction was originally done or scar tissue if an open gynecomastia procedure was done. It is not rare in my experience with the male gynecomastia patient. About 1/3 of men will return for a secondary revisional procedure for exactly the problem of the persistent puffy nipple issue.

Puffy nipples after gynecomastia procedure

If only liposuction was done for the chest, usually the puffiness was there before the suction. I call it a "nubbin" and it is a dense fibroglandular breast-like tissue that cannot be liposuctioned out. It will require some incision around the areola (pink skin around the nipple) in order to cut it out. In men these scars heal beautifully and are hidden in the natural color of the areola. Good luck. 

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.6 out of 5 stars 37 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.