Revision planned-Puffy nipples to fix, need help

[flatness13]

So at almost 10 months post operation I find that my surgeon removed too much tissue at some areas causing deformities, unevenness between both pecs(though they always looked different) and my nipples are still quite puffy and it's not just scar tissue. It's still an improvement though.

I am now only interested in fixing the puffy nipples. Next week first consultation with a reputable surgeon who I know has fixed several guys' nipples. Here are before and after photos:
pre-op
http://i1209.photobucket.com/albums/cc396/tanner151/before-gynoS%202.jpg
http://i1209.photobucket.com/albums/cc396/tanner151/pre-op%202.jpg
http://i1209.photobucket.com/albums/cc396/tanner151/pre-op%203.jpg

post-op
http://i1209.photobucket.com/albums/cc396/tanner151/post-op-front.jpg
left nipple crease when flexing http://i1209.photobucket.com/albums/cc396/tanner151/post-op-frontflex3.jpg
http://i1209.photobucket.com/albums/cc396/tanner151/post-op-sides.jpg

Obviously I want the excess tissue from the arreolas gone and hope this makes them shrink a bit. 2-Nipples started tilting downwards, can they become horizontal again? And 3- can something be done about my left crease? I am hoping this can be adressed with just "nipple correction" surgery because it saves me a lot of money and I can get this done with local anesthesia.
Thanks for your help!

[flatness13]

I hope I didn't discourage any input by making my post too big lol. If you could just give your opinions on the questions I asked it would be helpful, I am meeting my next surgeon this wednesday.

[Dr. Schuster]

I'm having  little difficulty viewing the photos but if I understand them right it looks like you have some residual tissue left behind. But also might have some adherent scar tissue. revision can be done with liposuction and / or open excision. You would really need an exam to tell. Good luck.

[DrPensler]

I did not review all of the photos ,I did review the last link. It looks as though you still have excess tissue present. To improve the result the residual tissue needs to be removed. I cannot tell what component of the residual tissue is fat and what component is glandular tissue without an examination.I would typically address this with a periareolar incision.

[flatness13]

Well the left side definitely has tissue left beyond just the nipple, or actually it could be an optical illusion because the surgeon removed too much from the lower part of the chest. I see a crater when I lift my arm up.

[Dr. Cruise]

Hi Flatness 13, 
It's a bit hard to see in the pictures, but I get the general idea of what you are concerned about. It does appear corrections can be made to improve the result. In terms of having the revision under local anesthesia, that will depend on the surgeon you are visiting. I don't see any reason why it can't be done under local, but this is how I perform a large number of my gyne cases, while others may not. 
Best, 
Dr. Cruise / Cruise Plastic Surgery