Puffy nipples after gyne surgery? (photo)

Sorry to say I do not see the issues in which you post.. Best to seek IN PERSON second opinions... //

Thank you for the question and pictures.
Given that you are still early out of surgery, some of the “puffiness” may be related to ongoing swelling;  resolution of the swelling and contraction of the overlying skin may result in the outcome that you saw initially and were pleased with. Sometimes the residual “puffiness” is related to residual breast and/or adipose tissue present.  It will be in your best interests  to be examined by your plastic surgeon  for accurate diagnosis and treatment recommendations. You should be aware that too much excision will leave you with a contour deformity and a “surgical look” that is aesthetically displeasing. I hope this helps.

If the areas were flat after surgery, then the appropriate amount of tissue must have been removed. Is it a collection of fluid? Consult and trust your surgeon or seek a second opinion.Best wishes

More than likely the puffiness is due to swelling which should get better with time, but this can take several months.

It is not uncommon to develop scar tissue after open gynecomastia reduction and it occurs on the timeline just like you have had. You should have some steroid injections to see if you can shrink it. If this has not occurred after six months ,then a touch-up open gynecomastia  reduction will be needed to remove the scar tissue.