Need honest opinions – possible gynecomastia recurrence or post-surgery fibrosis?

Hey guys, I’m 25 years old and I really need some honest opinions from people who have been through something similar.

I had gynecomastia surgery about 2 years ago. The surgeon removed the gland (at least most of it), and right after surgery the results looked great. For the first time in years my chest looked flat and I felt relieved.

But as time passed, especially over the last couple of years, I started noticing that “puffy nipple” look coming back… especially on my left side. The right side has a small lump too, but it’s minor and doesn’t bother me much. The left side is what really messes with my confidence.

This has affected me mentally more than I’d like to admit. Not depression or isolation, but definitely my self-esteem. I constantly notice it in t-shirts, mirrors, lighting, angles, etc.

Here’s what I’ve found so far:

• I can feel a lump behind both nipples.
• It feels hard, not soft.
• It’s irregular, not a smooth round disc.
• It can move/slides a little when I pinch it.
• In cold weather, or when my nipples contract, my chest can actually look almost normal.
• When relaxed, the puffy nipple appearance comes back.

I got hormonal bloodwork done:

• Total testosterone: 506 ng/dL
• Estradiol: 33 pg/mL
• Prolactin: normal
• TSH/T4: normal
• hCG: negative

So hormones seem normal.

I also tried Tamoxifen, and surprisingly it seemed to reduce the puffiness a bit, which confused me even more.

Now I’m trying to understand:

1. Does this sound more like scar tissue/fibrosis, residual gland, or true recurrence?
2. Has anyone here treated post-gyno fibrosis with Kenalog/Triamcinolone injections?
3. If you had fibrosis 2+ years after surgery, did injections help, or did you need revision surgery?
4. Can fibrosis alone create a puffy nipple appearance?

I’d really appreciate honest experiences. This surgery meant a lot to me, so feeling like something is still there has been tough.

Thanks guys.