Puffy Nipples Mean Gynecomastia

by Dr. Miguel Delgado

The breast bud in young men will grow to various degrees during the adolescent years. Puffy nipples may be the result and are more prevalent in younger men. The protuberance and fullness causes a dome shape of the areola and nipple from dense tissue of the breast. Right behind the nipple is the original placement of the breast bud during development in puberty. There is very little fatty tissue involved; it is mostly excess breast tissue. With or without any extra fat, this condition is still considered gynecomastia.

Dr. Miguel Delgado states that for most young men, the puffy nipples will resolve on their own without any intervention. For the unfortunate few that the excess breast tissue becomes permanent, gynecomastia surgery will be their only option. The procedure is the same as for “true gynecomastia” where an incision is made around the areola and the gland is removed from the deeper tissue. The fullness will be gone and the nipple and areola will shrink and flatten to the chest wall.

Some patients comment on how their puffy nipples seem to improve when they are cold or in the water. This happens because there is a muscle that contracts causing a tightening and flattening of the areola upon stimulation, but once the stimulation is removed, the puffiness will return as the muscle relaxes.
This can be a very traumatic time for young boys as they struggle through their adolescent years. Dr. Delgado recommends that parents wait until their son has finished puberty to see if their gynecomastia breasts will resolve on their own. Depending on how severe their male breasts are and how psychologically effected the boy is would determine when surgery could be anticipated. It is highly recommended that parents take their sons in for an evaluation with a Board Certified Plastic Surgeon that specializes in gynecomastia to help determine the best course of action.

The surgical treatment for puffy nipples has an enormously high satisfaction rate. For many young men it is possible that the “pull-through” procedure can be performed, it is a much less invasive procedure whereby drains are not needed, surgery time is much less and they have a faster recovery.