3 weeks after gynecomastia surgery my nipple is still puffy ? (photos)

Following surgery, your incisions will go through a maturation process. For the first few months they will be red and possibly raised and/or firm. As the scar matures, after 6-12 months, it becomes soft, pale, flat, and much less noticeable. You may experience numbness, tingling, burning, “crawling”, or other peculiar sensations around the surgical area. This is a result of the healing of tiny fibers which are trapped in the incision site. These symptoms will disappear. Some people are prone to keloids, which is an abnormal scar that becomes prominent. If you or a blood relative has a tendency to keloid formation, please inform the doctor.Bruising and #swelling are normal and usually increase slightly after the removal of any tape or foam. The bruising will decrease over 3-4 weeks, but may last as long as 6 weeks. The majority of the swelling will be gone within the first 3-4 weeks. However, it may take 6-9 weeks to disappear completely. Also, 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. The #compression garment helps reduce the swelling, and the longer it is worn, the more quickly you will #heal. It can also assist in the retraction of the skin. If you have any concerns about #healing, its best to ask questions of your surgeon or their nursing staff.

Hello,

Thank you for your question.

It is difficult to determine as swelling may
last a couple months.
Should this persist, I'd recommend booking a follow-up appointment
with your Board Certified Plastic Surgeon to discuss your concerns.

Take care.

3 weeks is very early and there is almost certainly some swelling yet to resolve, but what you describe could also represent fluid collection (seroma) or residual gland.  Discuss with your doctor.  I generally recommend compression garments for up to 6 weeks after gynecomastia surgery.