Gynecomastia doesn't always mean you have puffy nipples. You could have breasts that resemble a woman's, which is caused by having a bunch of gland throughout the breast area. Check out my pics to see what I'm talking about.
Those pics were taken when I was about 230lbs (I've lost a few pounds recently - I can't see a difference myself). I'm 6'3". I don't necessarily have puffy nipples but as you can see I definitely have breasts, and I know people much fatter than me without breasts like this.
I'm desperately looking forward to my surgery.