Bermant Gynecomastia Male Breast Reduction Plastic Surgery
Bermant Gynecmastia Male Breast Surgery

Male Areola Nipple Exam for Puffy Nipples and Gynecomastia

Documenting the Problem and Solution. Helping patients heal, the emotional component.

Michael Bermant, MD
Board Certified by the American Board of Plastic Surgery

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The Male Nipple Areola Examination

male nipple exam mirror and photos The before surgery pictures on the wall permit a direct comparison of the current chest sculpture progress since surgery. Thermomiter in room shows temperature to maintain consistency for exam and documentation. I tried to maintain a warm room of 75 degrees Farinheight. A cold room distorts the size by shrinking the thin under areola muscle. Looking in mirror, patient can check his current progress after surgery and compare to the before surgery images on wall. The before surgery pictures on the wall permit a direct comparison of the current chest sculpture progress since surgery.

Move over the question marks to learn more. The set of Photos on the wall varied depending on the patient's problem. These were my Standard Gynecomastia Pictures, the set with the surgical plan markings. There was also a framing shot for the video so I could better match my after movies to the before surgery camera settings.

Areola Diameter and Nipple Projection Measurements

Areola Measurement Width Documentation
Here the caliper was set to the areola diameter measurement from before surgery. This graphically documents the degree of shrinkage this patient had with his surgery.
measure nipple photoHeight Documentation
The caliper then was used to measure this dimension. The difference in each aspect varied from patient to patient.
measure nipple projectionNipple Projection Documentation
The caliper measures how far the nipple is above the areola chest skin junction and shows just how far his puffy nipples
projected before surgery.
The Jameson Caliper did not have a reach long enough for many before surgery large areola patients. I used a vernier caliper of sufficient size as seen in the top two photographs.

Instruments Calipers & Measuring Devices
The instrument for the nipple projection needs to have a flat blade or there will be tissue distortion in the measurement. As shown here in this lower pictures, I typically used a Jameson Caliper, 3-3/4" (9.5 cm), graduated in inches and mm with thin tips, chrome (advertisement). Something I regularly used in my operating room measurements documenting that the tissue dimension change happened in the operating room.

Not shown but taken was the anatomic nipple height: distance from the areola nipple junction to the tip of the nipple. This was critical for those with Long Nipples.

Documentation of Areola Diameter
This size shrinkage seen was amazing, and different for each patient. Just how much the nipple changes varies by surgeon's technique. After the demonstration for the patient, I then recorded the current measurement on the chart. This measurement documentation was a component of my analysis and evolution of my Dynamic Technique to target the gland first. Gland left attached in other surgeon's methods "to support the areola" leaves a firm structure that does not permit as much shrinking of the areola skin / muscle layers.

Recording Room Temperature
Room temperature is important for both comfort of the patient and a consistent result. There is a thin muscle just under the areola that shrinks / flattens the nipple with stimulation or cold. Once tissue heals, this contraction again begins to be an issue for documentation. That is why the room temperature should also be part of the record of a male nipple examination. I used a large display digital thermometer such as the one to the right (advertisement.)
Emotional Healing
In addition, the patient was given immediate feedback as to just what has been accomplished. The emotions I saw the patients express during the demonstration were so positive, I included this demonstration as a component of the emotional healing education. Here is a method to check just how well a technique actually works.

The before surgery Male Breast Examination also included assessment of the deeper structures and how tissues moved. Rarely this was supplemented, when indicated, with Gynecomastia Testing to help with the diagnosis.

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This page last updated on: February 27, 2013

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