Do the first stages of a gynecomastia look like the nipple has been pinched or is this an issue with the procedure style?(photo)

There are definitely a wide variety of difficulties that can occur with the nipple after the procedure has been completed. There is always the possibility of scarring that does not complete properly or in a flat manner. There is no way to tell if this is a definite as each case is different, and your doctor will be the best to tell you what to expect. 

Thanks for your question and this result is not very common but depending what was done and how you heal scarring can result in contraction of the tissues.  These will sometimes relax over 6-12 months.  If the procedure was done correctly these types of problems are rare. 

This is certainly not a common outcome of gynecomastia reduction.  I would not let one online photo spook you out of having surgery.  Most men are very pleased with the outcome of their gynecomastia surgery.  My guess is that for this one weird photo, there are a hundred good ones!

I have not seen a result like this from gynecomastia surgery, so I do not think this is representative of what to expect from the procedure. Certainly, the more excess skin someone has, the more the risk of skin laxity and irregularities unless skin is removed, but skin removal can leave very noticeable scars. Most patients do not need skin excision, and the skin will redrape satisfactorily. This photo looks like either an uneven or overly aggressive tissue removal, or a patient with way too much excess skin, and probably both.