In a way, it is possible to still have puffy nipple after surgery. You have to make clear your PS understands exactly what you want as far as a result. If the puffy nipple is a real issue to you, make sure that you stress this issue to the PS. I had surgery for puffy nipple and needed to go to another PS for revision surgery. Originally, my first PS told me after he removes the gland, my areola will shrink and flatten out. I said great , that's exactly what I want. Well, he did the surgery and as soon as the steristrips came off, which close the incisions, my puff nip was back and I was quite upset. The PS told me to give it about 6 mths for things to settle down. I waited the 6 mths and no changes. I went back to the PS and he said, "You look fine, don't be so critical about yourself". I said, "I want this fixed , what are you going to do about it". He said, "Nothing, your fine." Yes , I can't deny that their is an improvement in the contour of my chest, but the areola never shrunk up. Needless to say, went to another PS and cost me additional $4000 to fix. I had an areola reduction throught donut procedure and 1 mth post op and areola small and flat. Just what I wanted. Good luck to you!!!