Question for the Docs....

[Grandpa Bambu]

You guys say that males who have puffy areolas, the 'puffiness' is caused by mammary gland pushing the areola out. Well, I've been wondering.... why don't more women have puffy areolas? In fact, of all the female breasts that I have seen, very few have 'puffy' areolas. How do you explain this?

GB

[DCBR78]

I'm going to need photos of the breasts .. I'm only kidding.. I'll leave now.

[Dr. Elliot Jacobs]

Only some guys have puffy nipples -- the majority of men with gyne just have an enlarged breast with flat nipples.  Women can have a similar problem.  It is called a tubular breast deformity, in which some or all of the breast tissue is concentrated just under the areola.  This results in a puffy nipple or worse -- the breast becomes elongated and narrow, with a wide and dome-like areola. It looks like a "tuber" (like a zucchini). The breast tissue is not distributed evenly over the chest wall. And just as not every male with gyne has a puffy nipple, not all women have tuberous breasts.

Mother Nature likes to do things partially as well, so you may sometimes see a puffy nipple on a normal female breast -- same as with men.

You will probably not see many photos of tuberous female breasts because they aren't usually placed in magazines!

Elliot Jacobs, MD, FACS

[what2do?]

i would think that because of the natural excess breast fat on women, the puffiness is obscured unlike in men, who naturally have less fat on the chest to begin with ... from what i've noticed, slim men usually have the "puffies" ...don't you agree ?

[DrBermant]

You guys say that males who have puffy areolas, the 'puffiness' is caused by mammary gland pushing the areola out. Well, I've been wondering.... why don't more women have puffy areolas? In fact, of all the female breasts that I have seen, very few have 'puffy' areolas. How do you explain this?

GB

Both men and women can have "Puffy Nipples,"  this is really a contour issue. 

"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 Puffy Nipple Gynecomastia Picture Gallery begins to show some of the various problems patients have called "puffy."  As you look at the images, what they have in common with the female breast is a projection of the nipple areola complex.  This is a measurement I have made on my patients for many years and is the height the tip of the nipple projects over the edge of the areola.

I have had women asking me to flatten a projecting areola.  That is not realistic for those wishing the possibility of breast feeding.

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

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.  This is a different measurement I make, and extends from the anatomic nipple junction to the tip of the nipple.  Both men and women can have long nipples.  Reducing a male long nipple is much easier since there are no potential functional loss when ducts are ignored with the sculpture.

"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.  What you can see from these examples are breasts that look like early female breasts.  As a breast starts to grow for either sex, enlargement centers under the nipple areola region where the gland is located and attached to the nipple.

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

I prefer my Dynamic Technique that permits me to target  the gland first and then decide if the remaining fat is needed to rebuild the defect and minimize crater deformities.  For many of my puffy nipple male patients, I find gland closely adherent to the thin areola skin muscle.  Leaving that gland behind can result in a cast dome like shape projecting from the chest.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[MSJ108]

I'm going to need photos of the breasts .. I'm only kidding.. I'll leave now.

HAHAHA I love it!