Your Questions

Q: Dr. Eppley, I am a 21 year old male and I have a protruding nipple problem. My nipples have been pointy for about 2 years now and I get made fun of every day for it. I saw some pictures of your surgeries, and I was wondering I you could help me out by giving me some more information about how to help this embarrassing problem?

A:  The ‘protruding nipple’ in a male could be one of two problems. One type of male nipple problem is due to the development of breast tissue that lies right underneath them. This is the smallest gynecomastia (male breast enlargement) problem which I call areolar gynecomastia as the excessive breast tissue does not extend much beyond the areolar margin.  This can be treated by a direct excision of the areolar gynecomastia through a lower areolar incision to flatten the areolar mound from sticking out. This is a simple outpatient surgery done under anesthesia

The other male nipple problem is that the nipple itself sticks out but the surrounding areola is flat. This usually produces the ‘point’ that is seen sticking through a man’s shirt. This is not a true gynecomastic problem since the undelying breast tissue is nor overgrown. Excessive nipple projection can be reduced through a simple wedge excision and closure done in the office under local anesthesia.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am a man who is 37 years old. I am bothered by nipples which stick out too far. It is not just that they stick out too far when I am cold but they protrude all the time. It is embarrassing and has been so for years. I wear shirts to try and hide it but it is difficult particularly in the summer. They are often sore and raw from being rubbed on by clothes because they stick out. I just have to do something about it. How is nipple reduction surgery done in men?

A: Management of the excessively protruding nipple is usually done the same whether it is a man or a woman. The outer aspect of the nipple is reduced by a wedge excision, How much is removed depends on the patient’s preference. Most men want the nipples to be coimpletely flat while women prefer a small raised nipple that stands out above the surrounding areola. When done alone, this is an office procedure done under local anesthesia. Small dissolveable sutures are used and only bandaids are used as a dressing. One can shower the very next day and there are no activity or work retrictions. The scars on the nipples heal so well that they can not be found later in most cases.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Barry Eppley, I am a 15 year old male, and I have a excessive areola projection problem. My nipples have been pointy for about 2 years now, and I get made fun of every day for it. I saw some pictures of your surgeries, and I was wondering I you could help me out by giving me some more information about this procedure?

A: As a 15 year-old male, I regret to inform you that I am unable to communicate with you due to your age. In order to share any medical information with you, I must have a consent from your parents to do so. Even though we are just communicating on the internet, the same rules apply as if I was seeing you in the office. Patients under the age of 18 must be either accompanied by a parent or have verbal or written parental consent to talk to them.

Independent of the above e-mail inquiry, male nipple issues are fairly straightforward. Excess areolar projection signifies that there is a limited gynecomastia problem that may be restricted to just the areola. This can be treated by a direct excision of the areolar gynecomastia through a lower areolar incision.

Excessive nipple projection can be reduced through a simple wedge excision and closure. Both nipple and areolar reduction can be performed during the same procedure. This can be done under IV sedation or general anesthesia as a one hour procedure as an outpatient.

Dr. Barry Eppley

Indianapolis, Indiana