What causes the puffiness ? fat or gland?

[hollisterco]

I had the surgery about 5 months ago. Only gland was removed. I went to my PS last week and talked to him about the fact that i wasn't really satisfied with the results so he said: no problem, i will simply remove more gland tissue. The thing is, i only have puffy nipples and i'm 6'1", 170 pounds, so i guess i don't have much fat under my chest. I'm actually wondering what causes the puffiness ? Do i still have puffy nipples because he didn't remove enough gland or is it because he haven't performed lipo?

I still feel a lot of gland tissue but if he removes more of that, is it pretty sure i won't have puffy nipples or do i have to ask him a lipo too? You understand that i don't wanna go under a second surgery and have that puffy nipples again 5 months after..

Thanks for your answers.

[Idlewild]

Hi hollisterco,

Puffy nipples can be caused by both gland and fatty tissue. With gynecomastia sufferers, we tend to collect more fat in that area and in my example, I still had puffy nipples at 6'2 145 lbs when I extreme dieted in an effort to deal with it. I went down from my usual 170-180lbs.

It sounds like your surgeon left a sizable amount of gland tissue the first time around, rather than the usual bit for nipple support. Perhaps shop around for other surgeons?

[DrBermant]

I had the surgery about 5 months ago. Only gland was removed. I went to my PS last week and talked to him about the fact that i wasn't really satisfied with the results so he said: no problem, i will simply remove more gland tissue. The thing is, i only have puffy nipples and i'm 6'1", 170 pounds, so i guess i don't have much fat under my chest. I'm actually wondering what causes the puffiness ? Do i still have puffy nipples because he didn't remove enough gland or is it because he haven't performed lipo?

I still feel a lot of gland tissue but if he removes more of that, is it pretty sure i won't have puffy nipples or do i have to ask him a lipo too? You understand that i don't wanna go under a second surgery and have that puffy nipples again 5 months after..

Thanks for your answers.

There are many possible causes for Puffy Nipple Complication After Gynecomastia Surgery. Fat, gland, scar, and sometimes skin can all contribute to the remaining contour issue.

Options for revision depend on many factors. If you need to explain to a surgeon how to fix this problem, you have the wrong surgeon. Revision surgery is an art form and checking before and after photos is a good way to see what a doctor's skills are with this type surgery. You can see actual Pictures during Revision Gynecomastia Surgery here with my technique of targeting the firm gland / scar tissue first and then using my artist's pallet of surgical options to recontour the chest. Liposuction, usually micro-liposuction is almost always a component for refinement.
 
Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery