Provided you are in good health, it seems you could be a good candidate for gynecomastia surgery. The photos do not indicate whether you have extra glandular tissue, excess fat, or both. When the male breast becomes significantly enlarged, it is associated with skin excess and eventually a sagging, droopy appearance. This condition requires skin removal in most cases, in addition to the removal of breast tissue and excess fat. There are a number of surgical procedures designed to treat gynecomastia with major skin excess.Many patients that I treat have too much breast tissue to remove in a single operation without also removing breast skin. Complete or near-complete removal of excess fibrous and fatty breast tissue would result in a 'deflated' appearance which looks worse that gynecomastia - it looks like bad surgery. However, if the breast skin is not too droopy, most of these patient can be treated in a staged fashion and achieve an aesthetically ideal or at least vastly improved chest appearance with the same set of invisible or nearly-invisible scars that result from one-stage surgery of Type 2 gynecomastia patients. The first of the two surgeries is the same as what is described above for Type 2 patients, but the tissue removal by first liposuction and then by direct excision is limited to an amount that is not likely to create a droopy or 'deflated' appearance. Several months are allowed to pass, and during this time the skin of the breast area will contract in most cases as it is less distended by breast and fatty tissue excess. A second, similar procedure is performed eight to twelve months later, once maximum skin retraction and resolution of all minor residual postoperative swelling has been observed. In most patients an ideal and masculine chest appearance can be achieved without the need for skin excision and the resulting surgical scars. Staged surgery is perhaps less convenient than a single trip to the O.R., but the opportunity to avoid scars that are essentially not concealable out of a shirt makes the staged approach quite preferable for many patients. When evaluating a gynecomastia patient, I always think to myself "What would I want if I were this patient"? I am certain that if I had the opportunity to dramatically improve my appearance without obvious surgical scars, I would without question choose that option.As far as a tummy tuck, I would need to see more photos from different positions to see if you could benefit from liposuction alone, or even weight loss. A tummy tuck would likely be necessary only if you have excess skin. Your photos do not indicate that that is the case.