Q: I am a fairly muscular 20-year-old guy and am a junior in college. I starting lifting weights about three years ago and, while my chest has gotten bigger, so have my nipples. I have to admit that I have been taking muscle building supplements until about six months ago. My nipples are puffy and stick out so when I am wearing shirts it looks horrible. I really need a fix for this so that I can go to the beach again and feel comfortable taking my shirt off. Even with muscles, having puffy nipples does not make my chest attractive. I am at about 12-percent body fat now.
A: There is no question that there are certain stimulants that can cause breast tissue development and this is not the first time that I have seen it in bodybuilding young men. It is good that you have stopped taking the supplements even though that will not cause the breast tissue to regress. This will require surgical excision done through a lower areolar incision. Most likely they are lumps of firm breast tissue behind the nipple-areolar complex that is causing it to be pushed out and puffy. After surgery you will need to refrain from weight lifting for about two to three weeks to prevent the development of a seroma (fluid build-up) in the space where the gynecomastia was removed.
Q: I would like to have PRP treatment on my face.
A: When patients use the terms “PRP facial” or “PRP treatment of the face” that can imply multiple types of facial treatments using PRP, platelet-rich plasma. PRP is an extract from your blood in which the platelets and serum are removed from a small blood draw and then can be put back to the patient in multiple ways. Platelets are know to have a very potent growth effect. The application of PRP to the face can be done as either a topical or injectable approach. PRP injections can be done either alone or mixed with fat or filler to create a volumizing effect and are often dubbed as PRP facelifts or even the marketed Vampire Facelift. When applied as a topical treatment, it is done in conjunction with either fractional laser resurfacing or the dermaroller, both methods which create channels into the skin by which the PRP can be absorbed and exert its effects. While the science of whether PRP really provides an immediate or a sustained long-term effect in facial rejuvenation is unknown, having it injected with other agents (fat, injectable fillers) seems the most plausible for having its high levels of growth factor exert a tissue stimulating effect.