It can sound pretty unbelievable for many, but some men are very concerned about:
- how their nipples look,
- what the shape is,
- how big the nipple is, or
- whether they protrude or are visible underneath their tops.
The size and appearance of men’s chests can significantly impact one’s self-confidence and self-image. When it comes to aesthetics, the focus is not just on well-defined chests, but also on male nipples.
Despite being smaller than female counterparts, a man’s nipple can present aesthetic concerns and may cause discomfort and embarrassment.
Male nipple protrusion
Male nipple protrusion, also known as overly projecting nipple or puffy nipple, is an aesthetic concern for men. The male nipples can appear prominent that peak through their tops and vary in appearance under different weather conditions and emotional states.
Surgery for nipple reduction
It is possible to reduce the size of the nipples and make them smaller and less conspicuous.
Surgery for nipple reduction is relatively straightforward. It can be done in less than an hour. A patient can return home after surgery. Downtime, pain and discomfort are relatively minimal as it affects only the nipple region, so patients can basically return to close to 90% of their daily activities after surgery.
Patients just need to return to the clinic only for wound inspection and removal of stitches after two weeks. After that, they can resume full activities.
The results are relatively permanent, as once the size and shape are altered, they will remain very constant, regardless of whether the individual gains or loses weight, ages, or undergoes other changes.
Purely an enlarged male nipple issue, or are there other issues?
When I assess a patient who is concerned about the nipple size and shape, I often want to distinguish or differentiate them from having gynecomastia, pseudogynecomastia or just purely male enlarged nipples.
In many cases, it could be a combination of any of the above mentioned, because the underlying cause for every one of them is different, and treatment is different as well. If you diagnose the wrong treatment for the wrong condition, you may not be able to achieve the results the patient is looking for.
Assessment, consultation, and investigation are crucial steps in explaining conditions to patients and planning proper treatment. So when a patient comes in to complain about having a puffy nipple, the first thing that I look at and differentiate is whether the puffiness or what they’re concerned about is due to the nipple itself.
Nipple issues in women: Puffy, elongated & inverted nipples
Puffy or elongated nipples affect not only men but also women, especially mothers. Following pregnancy and breastfeeding, the nipple or areola may be affected in size and shape.
Some women also suffer from inverted nipple conditions. Some studies have stated that inverted nipples affect up to 2 to 10% of women, and as many as 10 to 20% of women were born with one or both inverted nipples.
Issues that inverted nipples can cause
Cosmetic dissatisfaction is among those who are affected.
- For women, inverted nipples prevent the ability to breastfeed naturally.
- Nipple soreness or inflammation during breastfeeding can occur due to clogged milk ducts.
- A sudden inverted nipple can be a sign of an underlying health condition, such as inflammatory disorders, cancer, infection, etc.
Inverted nipples: Their grades and how to retract them yourself
Inverted nipples can be caused by either congenital, meaning you are born with them, or acquired, affecting one or both sides. It can happen in both men and women, causing discomfort and functional limitations.
There are three grades of nipple inversion.
Grade I is what we consider an inversion, which can be easily pulled out with gentle palpation or manipulation with your hand or fingers. It maintains projection well without traction.
Grade II indicates that the nipple can be pulled out by palpation, but with much difficulty, and it tends to retract spontaneously after that.
Grade III is the most severe form of inverted nipples, characterised by a significant degree of inversion. Trying to pull out the nipple manually is almost impossible. There’s significant fibrosis between the nipple and the surrounding soft tissue.
Grade I and II inverted nipple non-invasive methods for breastfeeding
The suction method
For Grade I or II variables, the suction method can be applied to allow mothers with inverted nipples to breastfeed without any obstructions or discomfort.
These are used by gently pulling the inverted nipple outwards using suction devices, such as nipple retractors, nipple extractors, shells, and cups. Typically worn beneath the clothing or a bra for a period of time, it works by gently pulling or sucking the inverted nipple out, aiming to loosen the surrounding tissues.
This method enables mothers during breastfeeding to provide a smooth routine.
The syringe method
For the syringe method, mothers will be advised to use a cc inverted syringe before each breastfeeding session. It involves placing the base of the inverted syringe over the nipple and gently pulling it out until the nipple is evident.
The Hoffman Technique
The last technique is the Hoffman method, which involves using only the hands. To encourage nipples to protrude, place the thumbs on either side of the areola and press it down while pulling the thumbs apart.
All of these methods can be tried or attempted for those with grade I or II inverted nipples.
However, if the patients are grade III, it’s almost impossible to retract it naturally, and surgery is the only way to address this issue for those who are affected.
Surgery for inverted nipple surgery
Two types of inverted nipple correction procedures preserve milk ducts for patients with nipples that are between grade I and grade II inverted.
For grade III inverted nipple patients, inverted nipple correction with detached milk ducts surgery is primarily used, where the release of dense fibrosis is necessary to reverse or restore the condition post-surgery.
Inverted nipples post-surgery care
It is crucial to allow a few days for rest to facilitate recovery from heavy lifting and water activities.
Other than that, most daily activities can be performed by patients. Itchiness may occur as the wound heals, so anti-itch medication, avoiding scratching, moisturising cream, wound dressing, and other wound care measures may be helpful.
Scarring may occur, but it is typically confined to the area to minimise visibility.
