Do I have gynecomastia or pseudo gynecomastia? The skin under the nipple is a little hard. (Photos)

Thank you for the question and picture. Accurate diagnosis would necessitate physical examination. It IS important to differentiate  as uncomfortable as gynecomastia ( excess breast tissue) from lipomastia ( otherwise known as pseudo-gynecomastia or excess adipose tissue of chest wall). Treatment will differ depending on diagnosis. Having said that, your photographs and description are most consistent with the presence of gynecomastia.
Generally speaking, liposuction surgery alone is useful to treat lipomastia (an enlarged chest secondary to adipose tissue); rarely does it suffices as the only modality of treatment when it comes to treating true gynecomastia. Most patients with gynecomastia benefit from direct excision of glandular tissue plus/minus peripheral liposuction surgery.
My best suggestion: seek consultation with board-certified plastic surgeons who can demonstrate significant experience achieving the types of outcomes you will be pleased with. You may find the attached link helpful to you as you learn more. Best wishes.

You probably have a component of gynecomastia, and surgery would improve this.  If it ever bothers you or you become self-conscious about it, consult with a board certified plastic surgeon who can use liposuction and excision of the glandular tissue to treat it.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

You have gynecomastia up front with puffy nipples. There is no such thing as pseudogynecomastia. It's an unhelpful term, wishful thinking and should be removed from the dictionary.Gynecomastia is the appearance of a female like breast in a man. If your chest looks more like a female chest then you have it. It's caused by the excess of tissue on the chest. The most common cause is leftover tissue from the changes that occur in all males at puberty. It's harmless but it gets into you head and ruins your life. That's why you seek help and why we treat it.