Causes of puffy areola

[gyneman]

? I had excision and lipo about 8mths ago...Still my areola is puffy when relaxed and when stimulated are hard like rocks. I saw my original PS and he told me everything looks fine. I saw another PS for a consultation and the PS tells me my areola needs to be reduced in size, this is what's causing the puffiness...The new PS told me the tissue and fat has all been removed. What do you guys think? It's funny , that's what I thought should be done and he said it, that makes me feel confident in the Dr....Would you agree?

[MRD]

Hmm...thats a bit weird. Nipple reduction will just make it smaller in size, not less puffy. Puffy nipple is caused by the gland behind it, so if you still have puffing that means your PS didn't take out enoug gland or did not lipo out enoug fat around it. Thats what i think.

[Grandpa Bambu]

Puffy nipple is caused by the gland behind it.

I don't know about that dude. There are many women who don't have puffy areolas and I'm sure they have gland.

GB

[DrBermant]

? I had excision and lipo about 8mths ago...Still my areola is puffy when relaxed and when stimulated are hard like rocks. I saw my original PS and he told me everything looks fine. I saw another PS for a consultation and the PS tells me my areola needs to be reduced in size, this is what's causing the puffiness...The new PS told me the tissue and fat has all been removed. What do you guys think? It's funny , that's what I thought should be done and he said it, that makes me feel confident in the Dr....Would you agree?

"Puffy Nipples" is a common public term for gynecomastia. 

The problem is the the term puffy nipples is a phrase that mean so many different things to so many different people.  Words just do not convey the actual problem very well - images do a little better, but still are not the same as an actual in office evaluation with your doctor.  This Gynecomastia Picture Gallery of Puffy Nipples begins to show some of the various problems patients have called "puffy."

Putting up pictures (using standard views before and after surgery) is one way to discuss what the problem was before surgery and what has happened.   Options depend on what is really going on.

Options for treatment revision surgery for "puffy nipples" depend on the problem to be sculpted.

Let us try to look what I mean by the problem of the words only descriptions.  "Large nips", "puffy nipples," "puffed nipples,"  and "puffy nips" are a common terms many give to a problem that extends to the region about the areola.   The nipple is actually the central raised structure inside the pigmented areola.

"Puffed nipples" can be a problem for some that involves long nipples above the areola where nipple reduction alone helps.

"Puffy Nipps" can be a problem behind the areola that can take many forms.  The deformity is usually a varying combination of fat and gland.  The gland can be firm or soft, spread through fat, or be a condensed mass.  There is a thin muscle under the areola skin that can flatten tissue when stimulated. Unfortunately it is impractical to keep stimulating these muscles.

In many of these patients with "puffy nipples," there was no firm tissue under the areola, just fat and soft gland.  Here is one example of puffy nipples in a muscular male.  Here is another example of   puffed nipples.  Here is another patient with puffy nipple gynecomastia.

"Puffy Nipples" can also be a combination of gynecomastia and big nipples.

I prefer my Dynamic Technique that adapts to the problem found during surgery to minimize such issues as residual deformity after surgery.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[thatguy]

I think i have read that post before on a different topic

[DrBermant]

Maybe I'm sounding a little sinical but I just have a hard time believing Dr. Bermant is responding to these posts. He is a top surgeon and I find it hard to believe that he follows the board this closely. They are very detailed with many links to click on to help get the point across and they would take some time to put together.

Does he have someone that responds for him or is it actually the Dr. himself? The reason I ask is I read these posts with his name at the end of them thinking it is the Dr.'s advise being offered and not someone else but it just seems a little fishy to me. If it is The Dr. responding to these posts them my appologies in advance. I take these posts as gospel since they are from a Dr.

It is me responding (Dr. Bermant).  The problem is that the same question gets asked here over, and over, and over, and over again.  It is a waste of my time to start each answer from scratch and therefore I tend to pull the details from my prior responses.


I came on tonight to get feedback about the new format and navigation for my site:

http://www.gynecomastia.org/smf/index.php/topic,8688.0.html

I have enjoyed increasing the public's awareness and education about such issues like gynecomastia now for almost 30 years and try to take a little time each day to help educate.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[headheldhigh01]

a fair answer.  i've even quoted myself once or twice before just for convenience. 

[gyneman]

Since you are the one who is responding. Please answer my question directly. If I had no gland, tissue,or fat in the chest region and my nipple/areola complex is still puffy, would a nipple and areola reduction sound appropriate. Also, the Dr says he wants to do a donut procedure to remove loose skin, since I had excision and lipo already!!! 

[gyneman]

Hey guys!! Just to let you know...There is nothing making my areola and nipple puffy. When I squeeze my areola and nipple all that is there is skin nothing in or behind it!!! So in my opinion, "I'm no PS", but I would agree with the PS that some type of reduction in the areola complex is appropriate...I think it was just stretched for so long that it needs to be reduced...I dunno!!

[thatguy]

I have the same problem...my nipples are puffed out and my chest is even a little puffy again! Im now 6 weeks and it is extremely frustrating to the point i want to throw up when i think about it..Gyneman is ur chest a little puffy also??...there is also nothing under my nipple that would make it stick out that i can feel...DR. B..i know its hard without pics but please give some insight..could gland  have came back in as little as 4 weeks..could it be swollen still..?

[gyneman]

thatguy, I am going with this new PS....If there is nothing there under nipple or areola, in addition, gland and tissue is all gone; it's gotta be the areola and nipple problem...Trial and Error!!

[thatguy]

the only reason i question that is..would too much skin stick out, even when you put a shirt on...i would think that it would be wrinkled or something..

[gyneman]

Thatguy, I am not understanding your question. What do you mean by saying it would be wrinkled and too much skin would stick out!!