I'm 20 yrs old. Do I have gynecomastia or puffy nipple? How bad it is? (photos)

Yes, you do have gynecomastia.  Puffy nipples is a minor form of gynecomastia (by the way, gynecomastia means breasts on a male).  Puffy nipples usually indicate breast tissue directly under the nipple areolar complex.  The fat on your chest not directly related to the puffy nipples is known as psuedo gynecomastia, while that area directly under the nipple is referred to as true gynecomastia.  No form of exercise will decrease the puffy nipples and, in fact, if you lose more weight, then the puffiness underneath the nipples will even be more obvious.I emphasize with you however I would caution you to not waste any money on lotions and potions that claim to get rid of gynecomastia.  Surgery, unfortunately, is the only answer.

Hello and thank you for your question.Your pictures are not really sufficient to give you online advice. I recommend that you see a board certified plastic surgeon in consultation to get more specific answers to your questions which can best be addressed after a thorough history and examination is performed.Best of Luck to you!

The problem you are describing is not uncommon.  Is it a sever case of gynecomastia? No. But, it can be corrected surgically if you are bothered by this condition  Take your time researching your plastic surgeon and look at many photos. 

Mild protrusion over the nipples is the original problem, call it gynecomastia or puffy nipple but unfortunately there is no non-surgical option to get rid of  this issue. In this type of cases, the fibro-glandular tissue is accumulated mostly beneath the nipple and this has to be removed through a direct incision because exercise/diet cannot remove them. Find a board certified plastic surgeon to have a consultation with before making a decision.

Congratulations on your weight loss.  Keep up the hard work.  To answer your question, you have mild gynecomastia.  This can be corrected through outpatient surgery.  The fat content of your chest will decrease with additional weight loss and may decrease the severity, but will likely not totally resolve the issue.  Best of luck.