Gynecomastia is the medical term for men with female type breasts. Dr. Delgado explains to his patients that there is varying degrees of breast development for men. 60% or more of men will have some form of gynecomastia at some point in their life. It can develop in older men as they age, or it can affect the adolescent as he transitions through puberty. Some men may develop breasts due to legal or illegal drugs.
For the adolescent, the breast buds may develop resulting in what is referred to as “puffy nipples.” The breast bud is behind the nipple and areola and if it grows it pushes the areola and nipple out in a dome like shape. The breast bud is mostly breast tissue and very little fat. Most young men will find that this condition will improve, and the chest will return to normal without any intervention. However, for a small percentage, the breast tissue will remain, and the only option for correction will be by surgical removal. Puffy nipples are considered “true gynecomastia” as the treatment is the same as it is for the more developed chest. To remove the breast tissue, an incision is made around the areola, and the gland is removed, if there is fat involved some liposuction may be done. With the tissue removed, the areola and nipple will flatten and shrink back to the chest wall.
It has been noted by several patients that when they are in cold water their puffy nipples seem much improved. The muscle contracts when cold, which cause the areola to tighten and flatten, but once the coldness is removed, the muscle will relax and the “puffiness” will return.
As young men struggle through their adolescent years, the onset of “puffy nipples,” whether temporary or permanent can be extremely traumatic. Dr. Delgado advises parents to take their son who has any type of breast development to see a Board Certified Plastic Surgeon, who specializes in gynecomastia. The surgeon will be able to explain to parents and the adolescent exactly what is happening and what his options are. In most cases, the parents will be advised to wait a couple of years to see if the condition will go away by itself.
However, depending on the degree of development and how it is affecting the boy’s psyche will help determine how and when to suggest treatment.
There is very high satisfaction rate for patients who opt to have surgical intervention to get rid of their puffy nipples. For some young men, there is a less invasive procedure that they might qualify for. This procedure is known as the “pull through” procedure that in most cases does not require the use of drains, and surgery time and recovery are faster.