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Blog. Puffy Nipples or Tuberous Man Boobs?

We suggest that each patient with gynecomastia in South Florida seek the best man boob surgeon they can find, of course. But a category of men for whom this is especially true is those with puffy nipples, which in reality may be tuberous breasts. Why? Two reasons:

  • Puffy nipples caused by tuberous breast deformities are relatively unusual for guys, and therefore,
  • Few cosmetic surgeons have handled cases of this particular condition.

Fortunately, here in greater Miami, gynecomastia expertise is available. For men with tuberous breasts in our area, or those willing to travel, we can offer more than 35 years of experience with every form of moobs, including tuberous gynecomastia. If you suspect you have this issue, contact us for a consultation.

What Are Tuberous Breasts?

Tuberous breasts earn their unflattering name because they’re shaped somewhat like tubers. They can be called other names such as “Snoopy breasts,” referring to the famous beagle’s nose, and “zucchini breasts.” Due to their irregular appearance, they often cause patients significant distress.

Much is not known about why they occur, but we do know the mechanism that causes these unusually shaped breasts: they happen when the circumference at the base of the breast is constricted, forcing tissues to grow outward and downward. The effect can be puffiness under the nipples that’s barely noticeable to large, pendulous breasts with herniated areolas. It’s not unusual for a patient with tuberous breasts to have marked asymmetry as well.

Update: We’ve discovered a study by a team of Italian researchers that takes a step toward a greater understanding of this condition. These doctors found “a disorder in collagen deposition” associated with tuberous breasts, meaning that collagen forms differently in breast structures of these patients than in people with normal looking breasts. Furthermore, the team found two cases of identical male twins with tuberous breasts, suggesting a genetic component. The study was performed more than a decade ago and we hope more research will be done, particularly related to the cause of tuberous breasts.

Tuberous Breast Treatment

In women, cosmetic surgery for tuberous breasts usually involves enlargement as well as reshaping. The constricting tissue at the base of the breast must be released, and the breast envelope prepared to receive an implant or fat transfer.

When men seek treatment, they may not even realize they have tuberous breasts. In greater Miami, gynecomastia patients with the condition often see it as a case of puffy nipples or moderately sized man boobs. And, because the goal is smaller instead of larger breasts, we can often skip the step of releasing constricting tissue.

In mild cases, we make an incision around the rim of the areolas to remove breast gland causing the puffiness. We almost always perform liposuction as well, not just to remove any gland and fat that has spread beyond the nipple, but to loosen and redistribute skin to enable normal breast contours after healing.

Moderate to severe cases can require an extra measure of strategy for tightening loose skin. We’re happy to report that most of our South Florida gynecomastia patients experience sufficient spontaneous skin tightening after surgery, especially if they hit the gym and work on their pecs. Occasionally, a second procedure to eliminate small folds can be helpful. In rare, very severe cases, an operation akin to a mastectomy in women is the best plan. Guys then must then decide whether the additional scars, which do fade in time, are worth a flat, masculine chest under tight t-shirts.

Your Expectations

We invite you to contact our office about gynecomastia in Boca Raton, especially if you think you may have tuberous breasts. As gynecomastia specialists with 35+ years of experience as go-to man boob surgeons for patients worldwide, we have handled many cases of male tuberous breasts and delivered pleasing results.

Take a look at our before and after gynecomastia photos. In the main gallery, you’ll discover several men with mild to moderate tuberous breasts and see how much improvement we can create. You can see a few more cases in the before and after puffy nipples collection.

If you don’t live nearby and you can’t travel to South Florida for gynecomastia surgery with us, we strongly encourage you to seek out plastic surgeons who have practiced for at least a few years and treat several dozen patients with man boobs annually, if not more. As you arrange consultations, be sure to find out whether the prospective doctor has performed surgery for men with tuberous breasts, and ask to see images.
In these tricky cases, it’s doubly important to get the right results the first time around.


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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