Dear Rational7375, Thank you so much for your questions and sharing your photos. There is puffiness of the upper chest and also a mild droop of the nipple. This could be pseudo-gynaecomastia or gynaecomastia. Pseudo-gynecomastia and gynecomastia can both cause an enlargement of the male breast area, but they have different causes. The nipples can also be asymmetrical and this is also rather common and normal. Pseudo-gynecomastia, also known as lipomastia, is caused by an accumulation of fat in the breast area. This is more commonly found in overweight or obese men, but it can also occur in men who have lost a significant amount of weight and have excess skin and fat in the chest area. Gynecomastia, on the other hand is caused by an increase in glandular breast tissue, resulting in the enlargement of the male breast area. Gynecomastia can occur in males of any age, from infancy to adulthood, and it can be caused by a variety of factors, including hormonal imbalances, medication use, and underlying medical conditions. While both conditions can cause emotional distress and self-consciousness for those affected, the treatment options may differ. Treatment for pseudo-gynecomastia may involve weight loss and exercise, liposuction, or other surgical options to remove excess fat. Treatment for gynecomastia will require surgery specifically to remove excess glandular tissue e.g. the MELT technique which we have described in our publication in 2018 . Please click on the link below for more details. Hope this answers your questions! All the best!