Puffy or pointy nipples may be caused by glandular gynecomastia. If this is a concern for you, please talk to Dr. Katzen during your consultation. He will customize your treatment plan to use the best technique and incision pattern to correct your nipples. Large areolas can also be reduced during male breast reduction surgery. It's important to be honest with Dr. Katzen about your needs and goals in your consultation so he can ensure you get the results you want.