Can fatty tissue not glandular tissue cause puffy nipples?

[hitchcock]

29-year old male who has excess fatty tissue on chest. No sign of gland but in my opinion I have slight case of puffy nipples.

I had a consultation with a plastic surgeon and he told me that he's 99% sure there's no gland and that he would use liposuction through the areola to get rid of the excess fatty tissue. I am only 160 pounds and 5-foot-10, decent shape and I work out a few times a week. He said if there was gland he would then excise the gland during the same procedure.

He also said I don't have gynecomastia because when I raise my hands above my head it wasn't what he sees in most cases, something about the shape around the nipple area.

Anyway, can fatty tissue not glandular tissue cause puffy nipples?
What type of procedure is it for someone without noticeable gland - I know doctors say they only know for sure once in the operation - and only a small amount of excess fatty tissue over the chest?

What bothers me is that I can take my thumb and pointer finger from each hand and grab the excess fat right above the nipple, and to the left and right of it, which I'd love to have disappear in a perfect world and know only lipp can get rid of it.

[Litlriki]

While it's difficult to say for certain that you have glandular tissue or not, based on your description, I would anticipate a procedure involving liposuction and excision of sub-areolar tissue, which is what I do in most cases.  Typically, puffy nipples result from the presence of some glandular tissue, which must be excised. You may want to see a second surgeon who does a lot of gynecomastia surgery before proceeding with treatment.

Good luck,

Rick Silverman