The “Why Can’t You” of Puffy Nipples
Puffy nipples are a bit like that famous iceberg: what’s underneath is a lot more consequential than the part above the surface seems to indicate. That’s why we take extra time to educate our New York man boobs patients about the ins and outs of puffy nipples.
We often field “why can’t you” questions from guys with these seemingly small chest issues. One is:
“Why can’t you just remove the puffiness?”
It’s understandable that a patient might think his plastic surgeon could make a small incision around the areola and simply pop out the extra gland that’s the cause of the puffiness. In fact, that’s a terrible idea. This approach would almost certainly lead to a crater deformity. A gynecomastia specialist will treat the chest as a whole, removing both breast tissue and fat, as needed, and resculpt the entire mound.
(As an aside, some inexperienced cosmetic surgeons don’t fully understand the techniques required—therefore we treat dozens of patients seeking revision man boob surgery in New York each year.)
Our approach with puffy nipples is to make tiny incisions at the side of the chest or at the edge of the areolas, get a look at what’s under the skin, then put instruments of our own design to work. Our special cannula has a sharp tip we use to remove knobby breast gland. If there’s some fat that needs to be addressed for the sake of smooth contours, we turn on the suction and refine it. If we feel a crater may be in the works, due to space left behind after gland removal, we rotate peninsulas of fat tissue into the area, leaving the fat’s blood supply intact. Finally, we use our cannula to loosen and re-drape skin over the now sleek chest.
Take a look at some of the before and after puffy nipples photos in our gallery. The pictures may give the impression that we simply got rid of breast gland, but be assured that light contouring was performed as well. For contrast, look at the “before” images of patients we treated for reconstruction of crater deformities. You’ll see what overeager tissue removal can produce.
Sometimes our New York man boob patients have gland tissue localized under the nipple-areola complex, or NAC, that enlarges the whole structure. These guys may ask:
Why can’t you just reduce the diameter of the areolas?
That’s not a good idea either! A much better remedy is to remove the excess gland and fat, even if it’s a relatively small amount of tissue, and allow the NAC to shrink back into place. We often have our patients think of an inflated balloon with a circle drawn on its surface. As you let air out, the circle shrinks. That’s what happens with almost every patient we treat who complains of large areolas. In fact, we often see it take place on the operating table.
There are two reasons not to take a scalpel to the areolas to make them smaller. One is that if you don’t treat the underlying gynecomastia, the areolas may become enlarged again over time. The other is that patients end up with wide scars completely around the areolas, and it’s not unusual for them to stretch and become quite unsightly due to inevitable tension on the area.
We know that some patients come in to see us looking to improve the appearance of their chest with a quick procedure instead of surgery for man boobs. In our New York consulting room, we’ve found some believe that confining incisions to the NAC should do the trick with a shorter recovery and perhaps at a reduced cost. Unfortunately, patients who work with doctors who will do this often end up with poor results.
The reality is that gynecomastia is gynecomastia, and no matter how it manifests for each man, the chest needs to be contoured. Here’s the good news: we tailor each procedure to be as minimally invasive as possible. Most guys rest a few days at home and feel pretty good inside a week, and scars usually fade to be almost invisible, no matter where we place them.
That’s why the reaction so many of our New York man boobs patients have is, “I should have done this sooner!” Would you like to see what we can do for you? Call us at 212-570-6080 today.