Hi there,You have quite large gynaecomastia, which is enlargement of the male breast.Mostly this is simply inherited, or weight related. Occasionally hormone imbalances or some medications can cause it. A checkup from your family doctor may be needed to rule these out.The usual treatment of gynaecomastia is surgical removal of the breast tissue.The results however, are all about the skin. If the skin is elastic, and not too plentiful, and if the amount of removal isn't too much then none of your skin needs to be removed. This means that you can have very close to scarless surgery. Most of the excess tissue can be removed by liposuction, and the rest through a small incision at the edge of the nipple. The skin will then take up and not look loose.You are at risk of having loose skin after removal of the breast tissue. If that occurs, then skin removal results in a long scar across the chest, which is quite visible. How do you reduce your risk of excess skin?1. You are very overweight. Lose weight. I'm serious. You must do this, and it will solve a fair bit of your chest problem, and allow the skin to shrink back naturally to an extent. It won't remove the need for surgery, but it might remove the need to leave you visibly scarred. If you don't lose the weight and get lean, you've no chance of a good result in my opinion.2. Visit a board certified plastic surgeon in your area to discuss techniques of correction. I think that the more your excess tissue can be removed by liposuction to your entire chest, the less the chance of needing skin removal.3. A personal examination is needed by the surgeon to properly assess your skin elasticity, and their experience will further inform you as to whether you have skin elastic enough to retract and recover after the tissue removal. I hope you do all this, it will make a huge difference to your life quality and body comfort, and I wish you very well with it.Howard Webster.