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Blog. A Creative Proposal for Puffy Nipples

If only it were possible to shrink man boobs with external equipment! Some of our puffy nipples patients ask about non-surgical approaches to man boobs with various devices, and we regret having to tell them they just don’t work.

We noticed a guy talking about a creative “solution” for puffy nipples on RealSelf recently: CoolSculpting and Ultherapy. He had had one treatment with this combination and said, “Results were below what I was expecting.” He wondered if he should go for more rounds. We were glad to see the doctors who answered him all said “no.”

Interesting Theory

We can see why the combination might seem to make sense for puffy nipples. In CoolSculpting, an operator presses an applicator to the target area, freezing fat cells. The cells break down and are naturally eliminated by the body over a period of a few months. The equipment has been FDA-cleared (not “approved,” that requires a more rigorous review) for use in the following areas: chin, jawline, thigh, abdomen, flank, back and upper arm. Notice that the chest area is not included.

CoolSculpting does eliminate fat. Medical News Today maintains that patients average about 20% fat reduction in the treated areas. It does not affect the skin, however, which is where Ultherapy treatment would theoretically fill the gap. This machine uses ultrasound to tighten skin and stimulate collagen production. Like CoolSculpting, treatment is FDA-cleared. It is meant to be used on the brow, neck, chin and upper chest.
We presume that the RealSelf patient chose CoolSculpting to reduce man boob fat, then Ultherapy to tighten skin. Makes sense, sort of.

The Fatal Flaw

As a practice specializing in gynecomastia for more than 30 years, we’ve treated our share of mild cases of moobs and puffy nipples. Right away we see a fatal flaw in the CoolSculpting/Ultherapy theory—it doesn’t address breast gland. In our experience, 100% of man boobs cases need gland removal. Even guys with large fatty breasts have gland mixed in (fat tends to trigger gland growth), and men with smaller man boobs or just puffy nipples absolutely need gland excision. No amount of freezing or heating can accomplish this.

More Food for Thought

In case you need more reasons to reject this creative “solution,” consider these:

Uneven outcome: In our view, the “sculpting” part of the CoolSculpting name is a bit of a stretch. We’re not the only ones who feel this way. Here are quotes from two other board certified plastic surgeons who DO offer CoolSculpting treatment, but frown on it for man boobs:

CoolSculpting might reduce bulk, but can’t be used for precise shaping.

The results are uneven, inconsistent and with results that are less than patients desire.

CoolSculpting might be worth a try for a large pocket of fat—say a big belly pooch—that may look better if it’s smaller and not perfectly smooth. But “precise shaping” is generally just what our patients with puffy nipples want.

Lengthy time to results: It takes up to six months after CoolSculpting for fat cells to leave the body. In contrast, while man boob surgery results are not completely final for about that same amount of time, the puffy nipples are permanently fixed at the end of the operation—and they do not recur. The guys we work with are enjoying their new appearance within a fairly short period of time.

Another drawback in terms of timing is that CoolSculpting patients often benefit from multiple sessions, and it can be tricky to know when to go in for more treatment.

Satisfaction: According to RealSelf, CoolSculpting has about a 77% “worth it” rating. Ultherapy is rated a couple of points lower. That may seem passable unless you’re one of the quarter of patients who aren’t happy. What’s more, we think the chances of poor results when you’re undergoing treatment that’s “off label” (meaning not the use the equipment is cleared for) are probably even greater.

Cost: Taken together, the average cost of CoolSculpting plus Ultherapy (according to RealSelf) is pretty close to the average cost of gynecomastia surgery. If you need more than one session of either procedure, you’re almost certain to approximate or exceed the cost of male breast reduction.

What’s ironic to us is that a simple morning’s surgery with us in Boca Raton can fix puffy nipples for good. The procedure takes roughly 90 minutes, start to finish, then the patient is home to rest, taking a few days to a week off work. What’s more, RealSelf reports a 96% “worth it” rating! Compared to other ideas for getting rid of man boobs, surgery is the poster child for “tried and true.”

We’re waiting to talk with you about your puffy nipples. Plan to come see us and get the problem taken care of. Call 561-367-9101 and let’s talk about making it happen.

Photo by cottonbro from Pexels


Dr. Elliot William Jacobs is a board-certified aesthetic plastic surgeon who specializes in FTM top surgery, gynecomastia surgery, revision gynecomastia surgery and male breast reduction. He is a native of New York and has over 40 years of experience in his field. Dr. Jacobs is a highly respected and sought-after surgeon who is known for his skill, experience, and compassion. Whether you are interested in gynecomastia for the first time, or are looking to correct a gynecomastia you aren’t happy with, Dr. Jacobs can deliver amazing results.


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