It can be frustrating when puffy nipples persist despite using medications like Nolvadex (tamoxifen) and Arimidex (anastrozole), which are often prescribed to address hormone-related breast tissue changes. Since these treatments have not helped, it’s important to have a thorough evaluation by an endocrinologist or a specialist in hormone-related conditions to explore other causes and treatment options.

Next steps you can consider:

• Get a detailed hormonal assessment to check estrogen, testosterone, and other relevant hormone levels.
• Consider imaging studies like ultrasound to rule out any underlying breast tissue abnormalities.
• Discuss with your doctor the possibility of surgical options if the tissue changes are persistent and bothersome.
• Avoid self-medicating further without specialist guidance, as inappropriate use of hormone-modulating drugs can have side effects.
• Maintain a healthy lifestyle with balanced nutrition and exercise, which can sometimes help with hormonal balance.

If you want, I can explain more about how these medications work or what surgical options might involve. Meanwhile, please consult an endocrinologist or a breast specialist for personalized care.To narrow down potential causes, we will need some more information.I understand you're concerned about your puffy nipples and the lack of results from Nolvadex and Arimidex. To provide the best advice, could you please tell me your age and gender?