Is this Gynecomastia? Doctors say NO! Help :(

[NukeGyn]

Hey Doctors,

I suffer from what I believe is Gynecomastia from the age of 13. My main problem is my puffy nipples.
I am now 21.5 years old and have been training at the gym, 5 days a week, for the last 4+ years.
One month ago I decided to meet one of the best doctors in my country (Israel), with 28 years of experience, in order to ask him to operate on me. After half a minute of touching, he looked at me and said: "I will not operate on you. You don't have Gynecomastia, what you have is excess skin (if I'm not mistaken...), you are fine. Deal with it."
Of course I was very upset, so I asked to see another doctor (one of their best), and he also told me he thinks the doctor is right, and because my nipple is located at the very bottom of the chest, the result won't look good, and I should just accept the way my chest looks.

Photos of my chest: picsurge.com/Yba6Tq
Password: gyno123

4 Questions for you doctors:
1. Is this Gynecomastia?
2. If you can't tell for sure it's Gynecomastia just by looking at photos; what's the way to know? I mean, know for sure, not just guessing.
3. Would you operate on me?
4. Is the location of the nipple really that problematic?

Thanks in advance!
I'm in a really horrible mental state and need your help ASAP.

[Dr. Elliot Jacobs]

I could not disagree more!

You are very muscular and yet have some excess tissue and puffy nipples as well.

Would suggest you consult a gyne specialist in Israel or, if you are truly motivated, consider traveling to the US or the UK for such a specialist.

Dr Jacobs

[NukeGyn]

Thanks a lot Elliot!

Question is... why every doctor I went to see told me he won't operate on me?
My case is not normal? Is there anything unusual with my chest?
Maybe they are afraid the result won't look good? and if so, why?

[Dr. Elliot Jacobs]

No, your chest is not unusual -- you do have gynecomastia. 

There is a very fine line in your case between operating and removing too much or not removing enough.  Many surgeons are very leary about operating on such delicate cases.

I have operated on many such cases -- for me it is routine.  'Nuf said.

Dr Jacobs

[NukeGyn]

Thanks for the reply.

I talked with another surgeon who said he's willing to operate on me, but says there is excess skin that needs to be taken care of. is that true? it's not just removing some tissue?

[Dr. Elliot Jacobs]

You are young, muscular and I presume healthy.  In my experience your skin should tighten up all by itself -- without any need to excise redundant skin.  You should be able to have your surgery with minimal incisions.  If your surgeon feels otherwise, then perhaps you should seek still another opinion.  Remember, once the skin is cut to remove "excess" skin, the scars will be with you forever.

Dr Jacobs

[NukeGyn]

Couldn't agree with you more... going to hear some other doctor's opinion about that.

What about the nipple's location btw? Does it seem like it needs a relocation?
What does relocation means scar-wise? 

[NukeGyn]

BUMP

Would like to hear your opinion about the nipple's relocation please (Any Doctor's opinion ofc...)

[Dr. Elliot Jacobs]

The normal position of a male nipple is just above the infra-mammary fold -- it will vary slightly in position depending upon your physique.

In most circumstances, when gyne surgery is performed, there is a spontaneous slight elevation of the nipples.

I very rarely move a nipple surgically unless is is originally located below the infra-mammary fold.

Dr Jacobs