Do I have gynecomastia or does this look like excess fat from having puffy nipples? (Photo)

Thanks for the photos.  You probably have a mild case of gynecomastia.  Be sure to obtain an evaluation from a board certified plastic surgeon.  A small incision around the areola can safely remove the gland and give you a tight chest.

If you are unhappy with your breast size then you may want to consider corrective cosmetic surgery regardless of the cause, especially if you are not planning on loosing weight. Gynecomastia simply means that your breasts are too big and has features of a women's breast. There are varying degrees of gynecomastia ranging from puffy nipple to severe breast enlargement and/or breast sag. The severity of the gynecomastia will determine which treatment option is necessary. In most cases, men suffer from standard gynecomastia, which can be surgically treated as an in-office procedure under local anesthesia. For more severe cases, it may be recommended that you have your procedure under general anesthesia at an outpatient surgery center. Your consultation will determine which option is best suited for treating your gynecomastia.

Thank you for your question.I do not see any significant Gynecomastia. Do not worry too much about the skin that you feel when you pull on your nipple. I do not think weight loss will change this. You should make an appointment with an experienced Board Certified Plastic Surgeon who can further evaluate you and advise you.All The Best !