18 year old male. Puffy nipples since middle school. Is this gynecomastia that won't fix with time? (Photo)

Yes, you have small gynecomastia located beneath the nipple. The surgery should be extremely successful and easy to recover from. It is best to go to a surgeon who performs gynecomastia surgery frequently. Good luck.

Thank you for sharing your question and photographs.  Because of your current body habitus, as well as the 5 year duration of your appearance, I do think this is gynecomastia.  I would advocate speaking with an ASPS board certified plastic surgeon about direct glandular excision to cure the problem.  Hope this helps.

This is pretty classic gyecomastia. I would recommend an open excision of the breast tissue to treat it. A small incision around the lower border of the areola will allow access to the tissue for excision.  Make an appointment to see your nearest Board Certified Plastic Surgeon to see your options. 

Puffy nipples are considered gynecomastia. During puberty many boys develop puffy nipples/gynecomastia. For most it will resolve on its own, but if it hasn't resolved within about 2 years it most likely has become permanent and only surgery will correct it. You should see a Board Certified Plastic Surgeon for an evaluation. Good luck!

Based on your 5+ year duration and photographs, it is most likely the you have persistent gynecomastia, localized to small areas beneath the areolas and nipples.  Surgical removal of the excess tissue is the recommended therapy.  For definitive diagnosis and treatment recommendations you should schedule an in-person consultation with an experienced plastic surgeon.  

The most common cause of gynecomastia is residual tissue left over from puberty that can continue to enlarge over time. If it hasn't gone away after 2 years it will always be present not matter what you do. Diet, exercise and drugs will not change gynecomastia. The only treatment that works is a procedure to remove the tissue.

Hi Y,Alan,Thanks for the post and photos. This is a case of puffy nipples and is a form of true gynecomastia where there is too much breast tissue under the areola. It is not uncommon for boys going through puberty to develop some breast tissue growth but in most cases it resolves in a matter of a few years.  If you have had it 5 years and it hasn't decreased in size and you have a normal hormone panel, then it likely will not get better on its own. Sincerely,Dr. Dadvand

Good day, As per your photographs provided and your description of the last 5 years I do believe you have gynaecomastia. However, an in person consultation is necessary and I suggest you consult with a board certified plastic surgeon for more accurate assessment. Research various surgeons in your area who specialize in this surgery and compare before and after pictures as well as patient reviews to help you choose the best possible surgeon for you. Best of Luck! 

Hi  thanks for your question. From your history and the photographs you have shared it looks like you have gynaecomastia. You will fall into the category of grade1 or mild gynaecomastia. Surgical excision of the gland as a day care procedure would be the option for you. Meet a board certified plastic surgeon for evaluation and further management.

Thank you for your question on gynecomastia.
Gynecomastia can be mild/moderate/severe, without or withou ptosis, more glandular or more fat. 
From what i can see on your picture it seem that you have a mild form of gynecomastia localized behind your nipple. Mostly glandular, so I would recommend consulting with a board certified plastic surgeon of your area for a open excision, glandular tissue are hard to remove with liposuccion....
Best Wishes
Dr Genevieve FCaron, Board Certified Plastic Surgeon
Montreal, Canada