Puffy nipples (not much gland) and a flat chest, can I have an areola reduction instead of tissue removal? Male.

You have not provided photos so us surgeons are left to guess at what we think we would imagine seeing.I WOULD NOT recommend an areola reduction with a scar around the areola for what you describe. Your areolas are enlarged because there is something under them that stretched them over time. As a general rule, if you remove the tissue the areola will shrink accordingly. The scar around the areola can become very unfavorable indeed and should be limited to certain cases where it's a must. Seek out several opinions always if you have any doubts.

Puffy nipples are due to breast tissue underneath the nipples which pushes it up and stretches the areolar skin.  Treatment by reducing the areola is treating the symptom-- not the cause.  You would be left -- in time -- with a scar completely around the areola.  It would stretch out the areola once again (remember, the cause has not been treated) and the scar itself would widen.  You would be left worse off!  And, there is no going back -- the scar is permanent.Best treatment is to remove the excess breast tissue -- which must be done carefully to avoid a crater deformity.  When properly performed, the puffy nipple should like flat and flush with the surrounding chest skin permanently.  And, the areolar diameter will diminish spontaneously.  It is the far better way to go.For further information, please refer to my website (captioned below) which is exclusively devoted to gynecomastia.Good luck!Elliot W. Jacobs, MD, FACsNew York City

It is possible that a nipple reduction  may irmpove the puffiness. I would have to see you in person to be sure..

Your nipple appears enlarged because of the excess tissue and/or fat.  Should the enlargement is primarily caused by fats, a liposuction-alone approach will suffice.  A few tiny round incisions are used during surgery and they generally fade into almost invisible scars. 

However, most cases of male breast enlargement are caused by a varying amount of excess breast tissue.  In this scenario, a U-shaped incision right at the border of the lower areola is required to remove the offending tissue.  Again, most patients can expect well concealed scars.

Areola reduction for men, meanwhile, is generally ill advised.