Thank you for your question about male breast reduction, gynecomastia, chest sculpting, and possible need for gynecomastia revision. Since you are only five months after your gynecomastia surgery, it is too early to tell. I would suggest you wait a full twelve months after your gynecomastia surgery. The hardness you feel behind the nipple is probably residual scar tissue. At one year, I would re-evaluate the nipple hardness. If the hardness is still there, you and your plastic surgeon may want to consider further surgery. If there is residual scar or breast tissue, you may be a candidate for liposuction. If it is dense scar tissue, you may need a formal breast scar tissue resection. This would involve an incision and removal the hard tissue. On another note, you mention, your chest sags when you bend over. This means you have excess male breast skin tissue. If you truly have excess breast skin, you may need one of two breast surgeries, namely male breast VASER liposuction or male. Male breast VASER liposuction is optimal because the VASER heats the undersides of the breast skin and causes skin contracture and tightening. Alternatively, if you have a significant amount of male breast skin you may require male breast skin removal with an incision around the nipple or under the breast fold or infra-mammary fold. Good luck! I hope this answered your question regarding possible male breast revision surgery for gynecomastia and possibly excess male chest skin. If you have any other questions regarding male breast reduction, gynecomastia, and chest sculpting, please contact my office. Sincerely, Dr. J. Timothy Katzen