Puffy nipples. Causes ?

[COD4]

Doctors , what causes the puffy nipples ? I meant the whats happening inside the areola when we have puffy nipples? Is it the glandular tissue exerting Pressure to the areola ? We all know there is a muscle which contracts the areola and make it hard. When we dont have puffy nipples why the muscle is always contracted then ?
And when surgery is performed without liposuction on a guy with about 25% body fat is the areola tend to be puffy later too ?

So excision plus lipo will make the  skin stretch ? And areola to flatten too ? How can that happen. If the areola is streatched with the skin it should be larger in size ? Why it becomes smaller in diameter when it becomes flat after a successful gyno surgery ?

And imagine we did liposuction on the whole chest including under the nipple area and near the nipple area, is it possible to prevent nipple sticking to the muscle by massaging the area ? 

If we have a minor scar in the incision line , how can u inject steroid ? Because its a very small incision ? 

Please answer to my all questions. Im living in hell

[COD4]

Can any doc reply please ?

[Dr. Schuster]

it seems you are asking several different questions. Yes there is a little bit of muscle within the areola that flattens the nipple when it contracts. Puffy nipples occur when there is too much tissue beneath the nipple-areola, when the areola is muscle is too weak (herniation) or both. In general removing the glandular tissue beneath the nipple will solve the problem, even with a weak areola. Care must be taken to leave just a thin layer beneath the nipple or retraction can occur. Occasionally the areola is still too weak and puffy after resection. in these cases an areolar reduction is necessary.

I routinely include liposuction in correction og gynecomastia, even in lean guys. Not that I'm removing much fat at all, but that it provides for a wider area of skin shrinkage and less chance of retraction.

Hope this helps.