I have puffy nipples, since I was like 11 or 12, but as far as I can see it is not gynecomastia. (photos)

I am sorry to hear about the physical and psychosocial problems you have experienced. Based on your good description and photographs, it is highly likely that you are dealing with gynecomastia.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.

"Puffy Nipple Areola Complex" is among the most common forms of gynecomastia. This gland and/or adipose tissue accumulation can be located under the areola or can be slightly extended outside the areola, causing the areola to appear dome shaped.This form of #Gynecomastia can be found in all age groups but is more common in young adults.As each case is different, it is vital that you consult with a board certified plastic surgeon who is experienced in male breast surgery. The surgeon should determine if you are a suitable candidate for male breast reduction by liposuction or glandular excision. It is also crucial to have a plastic surgeon who is well-versed in the gynecomastia condition can determine if there is firm breast tissue beneath the areola that is causing the nipples to project (which is often the case), and if so, how much of this glandular tissue can be removed to create a flat appearance.#PuffyNipple surgery generally takes only an hour or two, and the recovery time is short; sometimes less than a week. There is minimal scarring and the success rate is excellent. Therefore, patients who suffer from "Puffy Nipples", and who view it as an unaesthetic and unpleasant condition, may desire surgical intervention to correct the "puffy nipple" condition. Men who suffer from large #areolas may notice that after breast surgery, the skin of the chest muscles will tighten, causing the areolas to tighten and diminish in size. This is a result of the removal of glandular and/or adipose tissue. The most important decision to be made before performing any surgical procedure is determining whether you are an ideal #candidate. 

I agree that the main issue with your Gynecomastia is the excess volume of the nipple-areola complex. Surgical treatment will solve this problem. We use a periareolar approach so the scar is practically invisible. We remove all excess gland behind the areolas and therefore achieve a flat (even when you are not cold) aspect of the chest. 

Since the area is small, the procedure can safely be done under local anesthesia or local plus sedation. Some patients that have tissue in the surrounding area, get more extensive procedures that can be done under general anesthesia.