Upcoming follow up, what is the best way to address these concerns? (Photos)

Just based off your photos (and not a physical exam) - perhaps behind the nipple areola - the surgeon removed a little more than anticipated which allows for the dent look. Open the conversation with them and state that is there any revision or future procedures that can be done to improve this outcome. (Usually want my patients to wait 8-12 months to really see what the full outcome is) - possible need a little more lipo done medially and maybe able to use that fat to place back under the nipple to help with the deformity. But definitely keep the weight done and keep to high protein and weight lifting to decrease your body's fat percentage to see this defect less.

Four months after surgery is considered early to evaluate result. It will take at least one year for wound to mature and scars to soften and settle. The entire area where your surgeon did liposuction and removed the gland is a scar and what you see now is a scar retraction causing deformity. As scar matures this is going to look softer. Worst case scenario, down the road (not sooner than 1 year after surgery) injection of fat grafts may correct mild deformity if present. Hope this helps.

Thank you for posting your question here!My answer will be limited by the data and pictures provided for a detailed and personalized plan I would recommend consulting with your surgeon in person.I am sorry that you are disappointed with your results so far , you seem to have put in the work as you look leaner in the after pictures. I would recommend honesty when talking to your surgeon , as a plastic surgeon our ultimate goal is patient satisfaction and if you relay your concerns to your surgeon I am sure they will strive to improve the outcome if they believe they can do so.it is hard to tell for sure from the pictures but there might have been some over resection done which can result in the crater effect that you see, gynecomastia surgery is a delicate balance and it is easy to over resect , this can be improved with a revision surgery , I would wait though before venturing into a revision surgery until you are at least 6 months out and things have settled down. Again I would encourage you to relay your concerns to your surgeon so they can come up with a plan that works for you.I hope this helps, best of luck!