Still have puffy nipples after surgery (1 month post-op with pictures)

[Timbucktwo]

I got my surgery 4 weeks and 5 days ago for gynecomastia that I've had since puberty and never went away.  I am 26 now.  Post-op I had to wear heavy padding and a compression vest for the first two weeks, lighter padding and compression vest for one more week, and then just a compression vest for about 10 hours a day (or at night when I slept) for one more week.  
So when I was first able to finally have my vest and padding off my chest after one week (only to take a shower/wash the vest) the areolas/nipples were completely flat.  It was when I was no longer wearing padding that my areolas starting to get a little bit puffy.  And now that I am no longer wearing a compression vest my areolas are very puffy (photos attached) like they were before surgery, maybe even more.  I guess they seem a bit hard if that helps too?  If I wear the compression garment over night they seem to be fine in the morning for about an hour or so then go back to being really puffy.
I know that one month is not that long at all after surgery but this just has me very worried (because all the swelling is gone from what I can see besides the nipples).  The surgeon told me he did a combination of liposuction/gland removal but I'm starting to doubt that he did the gland removal.  So I guess the question here is, did I get ripped off?  Or do you think my nipples will flatten over time?  
Thank you in advance!

[nonini]

I don't see the scars for excision, do you have scars around your nipple area? Definitely doesn't look right to me.

[Timbucktwo]

Yes there are scars just under my areolas, luckily those are pretty unnoticeable.  But yeah my surgeon told me he did liposuction and gland removal.  My nipples were flat until I didn't have to wear my compression vest anymore and now they're back to their normal puffiness.  The liposuction worked great, I have no boobs now, but the nipples seem like I didn't get surgery at all (which stinks cause I was more worried about the nipples than anything else).  Do you think that this is maybe swelling still?  Or maybe a seroma?  I just don't want to think that I just wasted $6,000 to still have puffy nipples.

[pharmacy2012]

Hi pal did how did your nipples develop did they settle back to flat or still swollen?

[Timbucktwo]

Unfortunately they are still puffy.

[Dr. Elliot Jacobs]

I deal with puffy nipples all the time.  Bottom line, if the nipples are not flat and flush with the surrounding skin initially and for weeks afterwards (with or without compression), then you may have had an incomplete procedure.  Compression can sometimes mask inadequate gland removal.

At this point, it would be wise to wait for everything to settle down -- perhaps 4-6 months.  Then return to your surgeon to discuss the results and if necessary, a possible revision procedure.  You may also help yourself by seeking another opinion with  a gyne expert in your area.

Good luck!

Dr Jacobs

[Timbucktwo]

Thank you Dr. Jacobs! I might go seek out another surgeon because of the screw ups on this surgery. The one nipple that is still really puffy still has no feeling in it and does not react to cold or anything. Whereas my other nipple still reacts to cold and did seem to shrink a little bit, the crimp is also quite annoying. Is that crimp something that is able to be fixed as well? And is there anyway I will ever get feeling back in my other nipple?

Thanks in advance!

[Dr. Elliot Jacobs]

Time is a great healer.  Be patient -- nipple sensation frequently returns slowly over time.

As for the "crimp" -- can't tell if it will get better but again, be patient.

Dr Jacobs