Your Questions
Your Questions
Q: Dr. Eppley, I have the exact condition of the 24 year old male described on your web page as “Case Study: Reduction of the Prominent Nipple in Men”. I’m 45 years old and enjoy running marathons and I think this surgery would greatly help my situation. I would hope I wouldn’t need to wear band aids during the marathons after the procedure, but even if so I would also would like to look better if I’m wearing a thin t-shirt or dress shirt. I don’t know what your schedule is like at the moment, but if at all possible I would like to get the procedure done right after my next marathon which is in May as I will be taking two weeks off after that before resuming training for my next marathon in the fall.
A: Nipple reduction is a very simple procedure that offers a permanent solution to the prominent and protruding nipple. I hear stories from men every week that speak to the same problem…’I can’t find shirts that hide my nipples’ or ‘Everyone asks me if I am cold’. Nipple reduction surgery is done in the office under local anesthesia. One only wears band-aids for dressings for a few days. One can shower and work out the very next day. Men do not report much, if any, discomfort. Once removed, the nipple will never grow back and one can wear shirts comfortably or take off their shirt without the embarrassment of nipples that stick out too far.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am curious about nipple reduction. I am an athlete with only about 10-12% body fat but I have nipples that stick out. I have always been self-conscious about the kind of shirts I wear or even taking my shirt off. I would like more information on what is best for my situation.
A: When one is concerned about nipples that stick out, it is very important to differentiate between true nipple protrusion and areolar gynecomastia. Both can cause protrusion from the nipple area but they appear quite differently on close inspection anad are treated with different techniques.
The commonly called nipple is really better understood as the nipple-areolar complex. There is a central protruding nipple surrounded by a flat pigmented areola. In men, the nipples are smaller because the size (diameter) of the areola is very small. In nipple protrusion or hypertrophy, the small central nipple sticks out while the surrounding areola is flat. This makes for a small point that sticks out in shirts. It is treated by a simple nipple reduction done under local anesthesia in the office. Most of the nipple is removed so it lays flat and will never protrude again. In areolar gynecomastia, there is a mass of breast tissue that pushes out the whole nipple-areolar complex. This is better called a ‘puffy nipple’. It is treated by removing this mass of breast tissue through a small areolar incision. This is done as an outpatient procedure under IV sedation or general anesthesia.
Dr. Barry Eppley
Indianapolis Indiana
Q: I want to know if my protruding nipples can be reduced on size and made to lay flat. I am a 23 year-old guy that has gotten big nipples just in the past several years. I never noticed them before but now that really bug me. I am very conscious of them and have to be careful as to what type of shirt that I wear or they will be sticking out and obvious. I want them to be flat and smooth with the rest of my chest. I have read that women can have their nipples reduced but can’t find that it is done in men.
A: Nipple reduction can be done just as easily and simply in men as it is done in women. In fact, it is actually easier in men because there is no effort needed to preserve nipple sensation or any height of the nipple. Also, men rarely have the degree of protrusion of the nipple that many women have making it, by comparison, an easier problem to cure.
In men, nipple reduction is done by a wedge-excision approach. This will completely eliminate the nipple and will make a seamless color transition into the areola as it is that tissue which is actually closed over where the nipple was. This will always make the nipple completely flat and eliminate any chance that it will ever protrude again. While nipple sensation will be lost that is rarely a concern for most men. It is a simple procedure done in the offiec under local anesthesia. There is no recovery or restrictions any activities afterward. Tiny dissolveable sutures are used and one can shower the very next day.
Indianapolis, Indiana
