Pinching them to make it look normal?

[flatness13]

I have heard this a lot from people who have pufffy nipples. They say that if they pinch their nipples a bit it will look normal for a short while. That's never been the case for me, even though I have a relatively mild case and they do look normal when they shrink if I get cold. What does this mean and does it factor in the surgery at all?

[hammer]

In my day, (I'm an old fart) we called that nipple hard on. Back then it was no big deal, but now guys are, well, candy ass'es and can't deal with it, so I guess you will need surgery!

[TigerPaws]

Careful hammer, using terms like Candy Ass shows your age.

[hammer]

Careful hammer, using terms like Candy Ass shows your age.

Hell, I don't care! I like my age, the house is paid off, I'm able to pay cash for everything, we are empty nesters, except for the daughter that just got out of the Navy, but she lives in the mother-in-law apartment so there is privacy too.
I don't think there is an age I would rather be!

[jrflatnow]

I have heard this a lot from people who have pufffy nipples. They say that if they pinch their nipples a bit it will look normal for a short while. That's never been the case for me, even though I have a relatively mild case and they do look normal when they shrink if I get cold. What does this mean and does it factor in the surgery at all?

Puffy nipples come from too much GLAND under the nipple.

[flatness13]

I have heard this a lot from people who have pufffy nipples. They say that if they pinch their nipples a bit it will look normal for a short while. That's never been the case for me, even though I have a relatively mild case and they do look normal when they shrink if I get cold. What does this mean and does it factor in the surgery at all?

Puffy nipples come from too much GLAND under the nipple.

I went to another surgeon and he says that it has to do with some kind of muscles and nerve endings in the nipples that don't work properly causing the soft puffiness.

[Paa_Paw]

Either or both could be true. There is a very thin sheath of muscle just below the skin that is reactive to a variety of stimuli.  Heat, cold, friction and etc. 
Sensitivity really means nothing.  Some men with very tiny nipples are very sensitive and of course the reverse can also be true.   

[flatness13]

Ok, and the surgeon says he has fixed puffy nipples by doing something to these muscles/nerves, so it wasn't about removing a bit of tissue underneath the nipples. Is this a legit way of fixing this? I haven't really heard of this method being dicussed by the doctors here.

[Dr. Elliot Jacobs]

Puffy nipples are due to excess gland tissue directly under the areolas and thereby pushing it out.  The amount of "puffiness" is due to the amount of tissue under the areolas.

Yes, it is true that mild puffy nipples can be made temporarily better by exposing them to cold, emotion or physical stimulation.  That is due to the small muscle fibers that are present.  They tighten the skin of the areolas (causing all the wrinkles) and push the excess gland down into the breast, thereby flattening the appearance.  But when the muscles relax, the puffiness returns.

It is absolutely impossible to remove muscle fibers or cut any nerves in order to improve puffy nipples.  (That doc has it completely wrong!).  

I treat puffy nipples with a combination of liposuction to loosen up the surrounding skin (so that the skin can re-distribute) and direct excision of the excess sub-areolar gland.  The net effect, if it is done correctly, is that the areolas will diminish slightly in diameter and the entire nipple/areolar complex will lie flat and flush with the surrounding chest skin. This happens immediately -- during surgery -- and remains so during the entire post op period.

The only exception is if some scar tissue develops under the areola.  This cannot be predicted or prevented during its development -- but it can be treated with appropriate cortisone injections.  Not everyone develops excess scar tissue -- I don't know why.

Bottom line:  puffy nipples require surgery to be cured -- and preferentially done by an experienced gyne surgeon.  It is a tricky operation, for if overdone, the result can be a crater deformity.

Hope this has helped.

Dr Jacobs