Puffy nipple but no gland = No true gyno?

[Andyc21]

From reading the posts on here, it would appear that true Gyno is where there is gland underneath the nipple? I have fatty puffy nipples but no gland. Does that mean I can reverse it without surgery? My body is in pretty good shape but my nipples are puffy and tender. I know there must be something wrong because they are tender but there is no gland so could it just be a hormonal issue and not true gyno that needs surgery? 

[DrBermant]

From reading the posts on here, it would appear that true Gyno is where there is gland underneath the nipple? I have fatty puffy nipples but no gland. Does that mean I can reverse it without surgery? My body is in pretty good shape but my nipples are puffy and tender. I know there must be something wrong because they are tender but there is no gland so could it just be a hormonal issue and not true gyno that needs surgery? 

All mammals have breast gland, it is a condition of being a mammal (both male and female.)  You can see typical Anatomy of Puffy Nipples will consist of gland, fat, and skin. Although fat tends to be soft and gland firm, fat can be firm and gland soft. Examination of the male chest alone will not distinguish gland vs. fat.

Fat does not tend to get tender unless through mechanical trauma or infection. Tenderness of the gland is one of many typical Symptoms of Gynecomastia that can be caused by an underlying problem of stimulation of the glandular tissues. Such a gland under stimulation may be swollen. Finding and treating the Cause of Gynecomastia is the first step. That usually involves an Endocrinologist, someone who specializes in this. Getting the problem stabilized first is the best way to minimize recurrence. Unfortunately, once the stimulation phase of gland goes down, there is residual deformity that may require surgery.

Gynecomastia mean that there is a female like breast contour on a male chest. Galen coined the term gynecomastia. He was aware of the gland component but was referring to the fat form of the contour problem. So "true" gynecomastia is just a contour problem. Pseudogynecomastia is a recent invention and a poor term as I describe on that link.

Hope this helps,

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

[headheldhigh01]

puffies are a milder form of real gyne.  non-surgical reversal is an option only in the earliest stages.  you'd have to consult a professional to get a reliable answer to your question. 

[Dr. Elliot Jacobs]

I have fatty puffy nipples but no gland. Does that mean I can reverse it without surgery? My body is in pretty good shape but my nipples are puffy and tender. I know there must be something wrong because they are tender but there is no gland so could it just be a hormonal issue and not true gyno that needs surgery?

If you are relatively slender and have protrusion of the areolas (ie puffy nipples) then you do have gland under the nipple which is causing the problem.  Gland need not feel firm -- in fact it can feel soft very often.  And fat does not preferentially decide to grow just under the nipples.  Tenderness is not something that fat exhibits -- but it is frequently seen with growth of breast tissue.

It is normal for all men to have some breast tissue-- and that tissue is located under the nipples.  If your puffy nipples have existed -- unchanged -- for two years or more, then more than likely there will be no help from medical treatment, exercise, weight loss, etc.  I would certainly recommend an endocrine evaluation first.  If the hormones are normal, then you may consider surgery.

Dr Jacobs

[rzr]

appreciate all doctors patience for responding thousands of question.I have the similar problem.My doctor-(plastic surgeon studied in Brazil) with pinch test said that I have more fat+small gland tissue which is causing the puffiness.But the ultrasound report says that "excessive subcutaneous fat and no traces of glandular hyperplasia".I am confused.I do not want to  undergo the incision method if gland is not the real cause.I already tried for 2-3 years doing cardio and weight exercise.I feel a donut shaped tissue under my nipple and my nipple not sensitive.

[calibrn]

I have the same donut type tissue but a hollowness in the middle?  Ive been on two consults and the both said just lipo.  And then I
said I do get some puffiness and they said well we may have to do an incision and remove some gland if it is there?