Hello Mikey Mike, Thank you for reaching out with your concerns about the position of your nipple areolar complex following previous gynecomastia surgery. It's great to hear about your fitness progress, though I understand your concern about the aesthetic aspects. From your description, it appears that your nipple areolar complex is positioned below the ideal line at the inferior border of the pectoralis major muscle, which is a common issue post-gynecomastia surgery, especially if substantial weight changes occurred afterward. To correct this, a procedure known as a crescent lift might be suitable. This involves making a semi-circular incision around the upper half of the areola, removing a crescent-shaped piece of skin, and then lifting and repositioning the nipple areolar complex higher on the chest wall. This method avoids the more extensive 'doughnut' lift, which you mentioned concerns about due to potential stretching and scarring of the areola. It's important to balance the aesthetic improvement with the potential for scarring. If the appearance of scars is a significant concern, it would be wise to discuss minimally invasive options or less extensive surgical adjustments with a board-certified plastic surgeon who has experience in male chest reconstruction. Ultimately, the decision should be based on a thorough consultation where you can express your concerns, evaluate before and after images, and align your expectations with what can realistically be achieved through surgery. Good luck, and I hope this provides clarity on your options for improving the nipple position. Sincerely, J. Timothy Katzen, MD, FASMBS, FICS Plastic Surgeon