Nipple after Gynecomastia Surgery, what are white dots around nipple? (photos)

As you heal, the area may feel “lumpy” and irregular. This, too, decreases with time, and massaging these areas will help soften the scar tissue. These white dots may be the lumps that can develop after surgery, and you may have the ability to manage them yourself with skin cream and massage. However, if there are any other concerns or worries regarding the feeling of the area then the best place to go would be to your surgeon in person. They would be able to answer all questions in relation to the details of your procedure and your condition both before and after surgery. Good luck to you.

Hello,  thank you for your question and photos.   Probably a granuloma occurred due to the sutures used 4 years ago during your surgery.  This can be corrected with local anesthesia as a minor surgery at the office. 

You have developed tiny cysts and scar tissue in your incision.   The cysts can be opened and this will help.   Attempts to remove scar tissue may not work so well. m My Best,   Dr Commons