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Blog. Puffy Nipples: Big Little Challenges

Like mosquito bites and paper cuts, puffy nipples create an annoyance factor far beyond their size for many guys who have them. Bodybuilders often develop puffy nipples after taking steroids or other supplements, and the enlarged tissue tends to mar the well-defined torso they’ve worked hard for. Regular guys can also develop a nipple-areola complex that sticks out, often for no apparent reason, and they often worry daily about who might be noticing.

Puffy nipples can be a challenge for plastic surgeons as well. It’s not a simple matter of just removing gland under the surface. We have performed revision gynecomastia surgery for hundreds of guys whose doctor did just that.

If puffy nipples are your particular headache, it’s important to have a good understanding of the condition so you can make sound decisions.

An Overview

Puffy nipples are just one form of gynecomastia, or man boobs. There may be a likely cause—such as steroids or other medications—in which case you can consider lifestyle changes (though the enlarged tissue probably won’t go away on its own). There may be no cause you can point to. In any case, we suggest doing plenty of research to develop your knowledge. There’s a comprehensive article hosted on the American Family Physician website; you could start there.

As you learn, one caution we have is to avoid becoming preoccupied with the makeup of your breasts. Many guys obsess about whether their man boobs contain gland or fat, and in our three plus decades of experience with gynecomastia, we’ve found it really doesn’t matter. Puffy nipples aren’t unusual, you may never discover why you have them and surgery is generally the only option for getting rid of them no matter what’s “in there.” Read our own overview of gynecomastia here.

If Surgery is Not an Option

Some guys with puffy nipples are not good candidates for male breast reduction for one reason or another. We’ve talked with many men through the years who have come to terms with their appearance. You can read our blog post about this, and you can join to find men who have chosen not to have surgery.

Some people can’t spare the time or the budget to have the procedure done right away, and these guys sometimes feel compelled to hide their breasts at all costs. Our best suggestion in this case is to invest in a compression vest or shirt. A good one should flatten your nipples, and if it should be noticed you can always say it’s for muscle support. We advise guys against using tape—it can cause irritation and even darken the skin eventually.

Electing Surgery for Puffy Nipples

If you decide to go ahead with gynecomastia surgery, know that reducing puffy nipples is just as tricky as any man boob surgery, perhaps even more so. Even if your extra tissue is a small nub directly under the nipple-areola complex, the procedure involves much more than pulling it out and placing a couple of small stitches.
To produce great man boob results, it’s all about achieving natural contours. That happens when you choose a board certified plastic surgeon with many years of experience with cases of all kinds. A gynecomastia expert will know just how much tissue to remove so that your nipples lie flat without crater deformities. He or she will also how to contour fat tissue as needed and re-drape the skin for a smooth appearance. (In our case, we use a cannula of our own design, often with the suction turned off.)

If you choose male breast reduction, finding the right plastic surgeon is critical, even if you have to travel to work with your doctor. We have operated on patients from far-off countries and on guys who live just a few blocks away in Boca Raton. Gynecomastia expertise is an attribute we’re known for, and we would be very happy to apply our skills to improving your appearance. Send us an email with your questions!


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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