What is this nipple problem actually? (Pictures!)

[Pufffy]

Hi guys,

It feels really weird to ask about this here, but I really need help before my surgery.
I posted this thread in another section before, but perhaps it is better suited for this one. (sorry for that, moderator!)

I am not sure what exactly my problem is.
What I can say for sure is that when my nipples are erect, the actual "nipple" protrudes further out than normal.
I visited a plastic surgeon about this and he thought it would be enough to do a nipple reduction, which basically just means cutting of the nipple to reduce its lenght.

But when I was at the consultation with the plastic surgeon my nipples very constantly erect, so he didn't see them "non-erect" which is when they look my "puffy" I guess.
When you look at my nipples in a relaxed state is seems that also the actual areola is standing out a bit? Or would this also be fixed with just cutting of the length of the actual nipple?

I here attach two pictures of my nipples, one when they are in a relaxed state and one when they are erect.
Would be very thankful for serious help from you guys.

The doctor I visited for the consultation has done gynecomastia surgeries before but I guess does not only specialize in this and works with all kinds of surgeries.

[Pufffy]

Here are some additional pictures when my nipples are NOT "erect", which is the "normal" state when it's not a cold environment etc.

(When they become erect they tend to become less wide and instead protrude further straight out, like you see in the first picture in the original post)

[Litlriki]

Based on the photos, you have a large and prominent nipple on both sides.  You may also have some mild gynecomastia, which makes the nipple a bit puffier, though this is less easily evaluated by photos.  If you're just addressing the nipple with nipple reduction (i.e. addressing what bothers you primarily), this is something I do under local in my office.  With patients who have the issue you have--both increased projection as well as a broad base, a little more tailoring is required to both shorten the nipple projection and to try and decrease the fullness and broadness of the base.  This can be challenging to achieve perfect results, but improvement can definitely be obtained.  A simple wedge reduction won't work, and the type of reduction where the top of the nipple is lopped off won't work either.  Be sure to show your surgeon your concerns in photos if you're not able to show him in the office, and try to be nice and warm when he marks you for the procedure.  Once local anesthesia is injected, things change a bit, so it's important to see the contour before the injection.

Good luck,

Rick Silverman

[Pufffy]

Thank you very much Dr. Silverman, for taking the time to answer me.

I understand that what is needed is not to just shorten the projection. Something must also be done about the base.

On the other hand I understand why the doctor i visited thought that only the projection was the problem. Here are two new photos when my nipples are "erect", like they were at my consultation. It actually makes them look much better and not puffy at all - however, when they are stiff they project even further out.

To be phrank, most of the times when I show myself without a shirt my nipples are stiff, which kind of makes me think that also just reducing the projection of the nipple would help them look a lot better when they are hard? But how would they then look when they are NOT "erect"? Even worse?

Of course I really want to get the very best possible result, and I would also be willing to travel somewhere in Europe to get this done by an expert. In worst case I could consider even travelling to the US, but that's pretty far.

If I do a much "lighter" surgery to start out with, such as just reducing the top of the nipple or a wedge reduction, I can do this under local anestesia here for only about a 1000 dollars.
If I do this, and I am content with the result when the nipples are hard, which is how they are most of the time in public etc, then I guess it's fine.
But if I am not satisfied with the result could I still then do a more invasive nipple correction in the future? Or would the first lighter surgery reduce my chances of getting a good final result?

Would be very thankful to hear from you other doctors also. Thank you again.

[Litlriki]

If your surgeon hasn't seen what your nipples look like normally, you should show him the photos you've shown us.  The nipple surgery can be a "first" procedure, and if you need additional surgery in the future, that's possible, but the surgeon should be familiar with what you have already had done.

Rick Silverman