What is the mortality rate or complication rate for gynecomastia gland excision under local anesthesia while awake?

The treatment of gynecomastia involves removing the tissue that is causing the chest to look puffy or enlarged. In most cases this involves removing 100% of the breast tissue. However, sometimes a very small amount of tissue may need to be left behind to avoid any contour abnormalities. For this reason, it is always discussed with patients that if they continue steroid use after surgery there is a chance that gynecomastia may return, albeit to a lesser degree.As with all cosmetic surgery, results will be rewarding if expectations are realistic. With any surgical procedure, there are some risks which your doctor will discuss with you during your consultation.There are three types of surgical treatment options available that treat gynecomastia. Your board-certified plastic surgeon will recommend the type best suited for you. The most important decision to be made before performing any surgical procedure is determining whether you are an ideal candidate. Weight, and more specifically body mass index (BMI), need to be considered when deciding. For instance, studies have shown that patients with BMI > 30kg/m sq (placing them in the obese category) have a higher complication rate. Therefore, it is important for patients to be as close as possible to their normal body weight prior to surgery. Not only will this decrease risks of complications, but will also enhance the aesthetic results. Further, normal body weight is different from one patient to another.

This procedure should be very safe.  Mortality should be nearly zero percent.  Morbidity from complications are related to your general medical conditions but should be acceptable.  Discuss your concerns with your surgeon.  

Mortality rate would be incredibly low, probably lower that the risk of just getting  to the doctor's office. The morbidity/complication rate should be slightly less than IV sedation or general anesthetic due to their additives risk. Possible complications  resulting from gynecomastia surgery are not frequent but include -Asymmetry during the healing processLumps or firmness under skinProlonged swelling (edema)Skin Pigment changesProlonged redness of the incisionLoss of Nipple/AreolaInfection#GynecomasticComplicationRate

 Risks associated with gynecomastia surgery include infection, bleeding, asymmetry, under or over correction, skin contour irregularities, loss or change of sensation, recurrence of gynecomastia, pneumothorax and the need for additional surgery.  Potentially life-threatening problems such as deep venous thrombosis/pulmonary embolism are very rare.
 My best advice: make sure that your surgeon  is a board-certified plastic surgeon who can demonstrate lots of experience, SAFELY achieving the types of outcomes you would be pleased with.
 Best wishes.

I prefer to use sedation or general for excision of male gynecomastia. The risks or mortality are extremely low, and morbidity like infection, fluid collection, skin loss, etc.. is pretty low.