23 year old athlete with puffy nipples

[Armadillo]

Hi guys!

I am a 23 year old martial artist that has had moderate puffy nipples since I was a teenager. There is little fat, just a hard glandular lump behind both nipples which is causing them to protrude and I have now plucked up enough courage to go under the knife.

Recently I visited a surgeon that does most of the gynecomastia surgery where I live. I made it clear that having a flat nipple that followed the contour of my chest was what I wanted. He has recommended that the best way to perform the procedure for minimal scaring is to cut straight across the nipple itself and extract the tissue this way.

Basically I am just unsure if this is the ideal way to carry out the operation in this case as I had thought that an incision around the bottom of the nipple was best for concealing scars?

BTW.  I had a DXA scan several months ago showing that my bodyfat was 6.2% so I am pretty lean and have always been in good shape. It will be hard to take a break from training for a while but its a small price to pay as I'm sure you will agree.

You're suggestions are very much appreciated.

Thank you very much.

[George Pope, M.D.]

I have seen a couple of patients with scars across the center of their areolae, and for the life of me can't understand why incision were made there.  The incision along the underside of the areola heals beautifully, and the color mismatch with the lighter chest skin helps to camouflage the scar.  I'd check around if I were you, or ask your ps about that.

Dr. Pope, M.D.

[DrBermant]

Hi guys!

I am a 23 year old martial artist that has had moderate puffy nipples since I was a teenager. There is little fat, just a hard glandular lump behind both nipples which is causing them to protrude and I have now plucked up enough courage to go under the knife.

Recently I visited a surgeon that does most of the gynecomastia surgery where I live. I made it clear that having a flat nipple that followed the contour of my chest was what I wanted. He has recommended that the best way to perform the procedure for minimal scaring is to cut straight across the nipple itself and extract the tissue this way.

Basically I am just unsure if this is the ideal way to carry out the operation in this case as I had thought that an incision around the bottom of the nipple was best for concealing scars?

BTW.  I had a DXA scan several months ago showing that my bodyfat was 6.2% so I am pretty lean and have always been in good shape. It will be hard to take a break from training for a while but its a small price to pay as I'm sure you will agree.

You're suggestions are very much appreciated.

Thank you very much.

Each surgeon has his / her own techniques.  You should carefully evaluate many before / after pictures to better understand what a specific surgeon offers.

Puffy Nipple Gynecomastia comes in many different shapes, sizes, and degrees.  Options depend on many factors.  However, I rarely use an incision across the areola as this is not a natural contour to hide a scar as the edge of the chest areola interface.  The exception is the unusual case of gland limited to the anatomic nipple itself with a flat areola.  Then the incision is still limited to the nipple itself, not extending to the areola just like my Nipple Reduction Surgery.  The other time I am dealing with mid areola scars are during Revision Gynecomastia Surgery when the original surgeon left a scar there needing revising.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[Armadillo]

Thank you both very much for you're excellent and informative replies.

I still am not sure why the PS wants to perform the procedure this way, but he did seem sure that this was the best way to keep scaring minimal.

I will get more information when I next see him and shall report back here.

Thank you once again.

[Armadillo]

OK, on Feb 9th I had the surgery.

I had asked the surgeon in advance about my concerns about the procedure (incision across the areola) and he assured me that it was indeed the best way to carry it out and he has lots of experience with this. He had previously used the usual method of making the incision at the bottom of the areola but had supposedly found that cutting through it concealed scars better.

I somewhat apprehensively trusted him and decided to go for the operation with him as I wanted it done sooner rather than later.

Anyway 3 weeks on the scaring is highly visible, the scars do not look the same shape on either side of my chest and lastly the nipples are still puffy. This has left me very upset right now as it looks so much worse than any other post op pics that I have seen at about 3 weeks and it clearly looks like the nipples and areola have been worked on. I will post photos soon when I can figure out how to post them.

So currently I do feel quite annoyed with myself that I perhaps didn't do enough research which is not like me at all, and have chosen the first surgeon that I was recommended to by my doctor as I was eager to have the operation ASAP.

A few questions;

1. Should I be wearing a compression garment? I was told that it was not necessary for me to wear one.
2. Is there anything that I can or should be doing at present to make the scarring less noticeable?
3. I realize I have no photos posted yet but what is the soonest that revision surgery is usually considered?


Thankyou in advance.

[mrpower33]

Any updates?

[Cellar_Door]

Did he remove the glandular tissue?

Please provide photos, if possible.