Only liposuction for puffy nipples

[puffynipplezz]

I've had puffy nipples for a long time. I recently started consulting plastic surgeons.
I had an ultrasound and visited 4 surgeons. Ultrasound shows bilateral breast tissue and no additional fat tissue: I am realy skinny (6' , 152 lb) , I have nearly no fat around my pectoral muscles and I look like this guy: https://upload.wikimedia.org/wikipedia/commons/6/62/Puffynipple2.jpg My only concern is my areola.

Anyway, the first three doctors said i need incision below my areola to remove the extra breast tissue and there's no need for lipo. The last surgeon i consulted said that laser liposuction right behind the breast tissue will help, removing the fat there (which is very small) will create connective tissue which will "hopefully" pull and shrink my nipple.

Of course i was shocked with this approach becouse it sounds like just a matter of luck but my PS insisted that there is a great chance of success and no risk of inverted nipples or keloids. He also said i should give this a chance becouse i have "nothing to lose" and incision surgery will always be there as an option if i wont statisfy with the result of lipo.

I think this is a temporary solution at
best becouse if i continue some lifting after surgery, the hypertrophy of pectoral muscle will make my nipples pop out, am i right? I realy wonder what you guys think about this surgery technique.

[Dr. Elliot Jacobs]

The treatment of puffy nipples on a skinny guy is very tricky.  First, the puffiness is due to breast tissue, which will NOT, under any circumstance, be adequately treated with laser lipo.  Laser lipo works on fat, not breast tissue.

If you are very thin, then liposuction to remove fat obviously shouldn't be done.  However, I use the liposuction instrument (called a cannula) as an instrument as well.  I use it to undermine the tissue surrounding the puffy nipple -- but there is no suction turned on. This will allow for re-distribution of the surounding skin after the tissue below the areola has been removed. Then, a small incision around the edge of the areola will allow for appropriate removal of tissue so that the nipple will permanently lie flat and flush with the surrounding skin.

Do yourself a favor and go to an expert in gyne surgery.  Ask to see before and after photos of patients similar to you.

Good luck!

Dr Jacobs

[Dr. Cruise]

Treatment of puffy nipples cannot be address with liposuction alone.  Liposuction will not remove this breast tissue. A small incision around the areola is needed for the breast tissue to removed beneath the nipple. Fortunately, the incision is well hidden and typically heals very well, so visibility is really a non-issue. You can read here for more info. about Puffy Nipple treatment 
As mentioned by Dr. Jacobs, be sure you are consulting with board-certified plastic surgeons who are experienced with gynecomastia correction. 
Best, Dr. Cruise