Thank you for the question.
I have found that gynecomastia is often best treated with partial excision of the prominent glandular tissue as well as liposuction surgery of the peripheral chest area. If the prominence of the chest wall is caused by adipose tissue, then liposculpture surgery alone may suffice.
Regardless of the exact procedure performed, local anesthesia is used during the procedure. This allows for a relatively comfortable immediate postoperative recovery. Afterwards, for most patients, a few days of narcotics may be necessary.
I would strongly suggest that you seek treatment with a well experienced board-certified plastic surgeon.
Best wishes.