Q: Dr. Eppley, I am a 27 year-old male. I have my nipples removed 8 months ago because it was too sensitive. I know the male nipple can be highly sensitive sexually and most of the men enjoy it but in my case I am unhappy with this sensation from childhood because it is intolerable and disgusting. And you know more than 30% male do not like that. I am among those men. So if someone tell that it is one kind of mental disorder, I do not believe it since I have taken mental and skin treatments since 2007 but there was no progress and I do not want to spend anymore money for medication. However, after the reduction of nipple there is little sensation on the center of the areola until now. When this place is pressed, it make me feel of the same sensation that I felt before. Finally, I have decided to remove the areola totally and want to make this place permanently numb. So what I want to achieve is the following:
1. Permanent numbness on areola by removing them.
2. Removing breast gland. (Actually, I have removed breast gland before but just need to check whether any gland tissue left. If it is then need to remove it.)
3. Removing whole areola. (It is not just the upper surface but also inner part. I mean after removing areola it will looks like a hole on skin.Probably, numbness surgery and whole areola removing may be at the same time.)
#2 and #3 is not mandatory but #1 is mandatory for me. #2 is optional.
*** It is notable that My problem is not gynecomastia. This surgery will be just for numbness on areola place to live rest of life with happiness. I think it can be done by local anesthesia.
A: The most likely reason you only lost partial nipple sensation is that only the tops of the nipples were removed. The nipple and its ducts extend deeper which is where it receives its nerve supply and sensation. While initially after surgery the nipples were completely numb, some feeling has returned because these deeper tissues remain. While the entire areola can be removed, it should not be necessary to do that to eliminate all sensation permanently. A lower areolar incision can be made and all tissues removed right up to the underside of the dermis of the areola. When this is done, the remaining areola is just a cosmetic feature on the outer side of the chest skin. As you have mentioned, removal of the areola will result in a purse-string type scar on the chest wall which may be indented. I am not sure that is a good trade-off but only you can make that decision. I would agree that either approach could be done under local anesthesia.
Dr. Barry Eppley