Area around breast still looks the same, do I need a second surgery? (Photos)

Dear sebstan,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

If your photo is the post op result, I agree that the final results could be better. Most guys with gyno need both liposuction and glandular removal in order to get the best result. Some guys with poor skin elasticity also need some skin removal, which can be done in a couple of different ways. You should return to your surgeon to see if you can get a revision. This would be your most economical solution. Good luck.

In Gynecomastia is very important to evaluate 5 important anatomical issues:
Amount of Breast tissue, degree of saggy skin, position and size of the areola-nipple complex, position of the inframammary fold and the lateral chest fat.
You have still a large amount of breast tissue to remove, you have significant saggy skin which makes your breast look very round, the areola-nipple complex is hanging, the inframammary fold is in a very low position and creates a round lower pole appearance, and a thick lateral torso.
So you will be candidate for a Subcutaneous mastectomy to remove all the mammary gland, skin removal through a curved natural incision right on the correct position of the masculine inframammary fold at the level of the Pec muscle, nipple areola free graft to reposition them in a male chest position and liposuction to lateral chest.
All above way more complex than just breast tissue removal, but your case is complex.
Be encouraged!!! You will end up having a very attractive flat masculine chest.
Dr. Cárdenas