San Jose, California-Some men believe “puffy nipples” are not true gynecomastia since it is only the areola/nipple complex involved. However, this is not the case; the puffy nipple is caused by breast tissue just under the areola/nipple giving fullness to the nipple as in a dome effect. This condition is more common in young men, and it develops during puberty. The breast bud can grow to different sizes, but much of the time it will resolve on its own after puberty.
For those men that continue to have puffy nipples long after puberty, the only resolution is male breast reduction surgery by excision of the gland. In the same manner as for true gynecomastia, an incision is made around the areola, and the gland is dissected from the areola and deeper tissue. This removes the fullness allowing the areola and nipple to shrink and flatten.