Looking at your pics your body is what is described as "skinny fat". Meaning, you have a high proportion of body fat to muscle. This is easily corrected with diet. Eating less carbs, cutting out processed sugar and increasing your healthy fat/protein intake. And a good weight lifting regime.
Your chest will not be improved by lowering your body fat. In fact, a lower percentage of body fat can make the condition look worse as it accentuates the tissue around the nipple, which doesn't respond to weight loss.
If you are done with puberty, I am very sorry to tell you your only option is surgery. If you do elect for surgery, the following weeks after would be an ideal time to get your body fat lowered which will give you the flat, contoured chest you're looking for.
I don't know any US based surgeons, but if you take a look at the featured doctors on the right hand side of this website, you will see Elliot Jacobs listed. I have looked through his website and some of the cases he has worked on and I can see his work is exemplary.
I've been where you are and now I am nearly 4 months post op I can say it was one of the best decisions of my life. I returned from a beach vacation last week and to be able to take my top off and not be self conscious was surreal.
Yes, I definitely drew the short straw when it comes to genetics--skinny fat and gynecomastia. I started eating a really clean diet about a year ago. Before that, and especially during my teenage years, it was a lot of crappy, processed foods and sugar. Right now, I'm at 2100 calories with 50% protein, 30% carbs, and 20% fat. I'll lower the protein and add carbs in about a week when I start phase 2 of P90X. The program is healthy balance of weightlifting and interval training cardio.
The cost really starts to add up if I have to travel to Chicago or NYC for surgery. In the US, it's not really feasible to drive or take a train across the country. For long distances, we have to fly, and it's incredibly expensive. I live in the Pacific Northwest, but my family lives near Dallas, TX. Either of these markets are available to me, but I can't find much information about surgeons in either area (Dallas/Austin/OKC or Eugene, Portland, Seattle). It's very sporadic and inconsistent.
Anyway, after reading everyone's comments, I'm nearly 100% sure that I'll get the surgery. Now, I've just got to figure out the logistics and get over the fear of having a surgeon mess up and leave me looking even worse
I think you should definitely have the surgery.
The severity of my gyno was just a bit less than yours, (I'm 24 as well, had this since age 12, and about the same height as you but a bit heavier due to more muscle) and I can tell you that lifting seriously for the past 6 years to make the gyno go away (I now know you can't exercise the gyno away, but that's the reason I originally started lifting) has not helped, if anything it made it worse, by accentuating it - like N8712 said. I can also relate to the 'avoidance tendencies' and stuff like that, gyno has been a big contributing factor to my depression the past two years and I've been single for the past 5 years.
I finally had the surgery done last week and am still recovering. To be honest, I'm not sure if I'm 100% happy with the results, but 1. it's probably too early to tell, and 2. I'll probably never be 100% satisfied with how my chest looks because my genetics are shit and my chest has a terrible shape to it.
You say your parents are near Dallas, TX...I'm in Plano, which you probably know is quite close. My surgery was done by
Dr. Dr. Wilcox (you can see his picture on the right of the screen) and do some reading on his website and watch some of his videos on YouTube). I think he is supposed to be the best in the area. The technique he uses goes in through the side of the chest (near the armpit) instead of the traditional method of cutting just below the nips. I think I prefer that. Also, they have a free consultation there, which is why I originally went, because the doctor I was looking at before him was charging $100 for a consult and $8k total for the surgery.
Dr. Wilcox charged me $5200 for excision of the glands and lipo. The whole process was made easy by the staff (anesthesiologist and nurses), as easy as you could expect a surgery like this to go. I still don't know what I will think of the post-op results (because that is still a couple months away), but I can let you know when I come to a conclusion. I'm not sure how long you are willing to wait, I just couldn't fucking live with it any more...12 years of hell, I couldn't bear another month.
Also, they have a payment plan with CareCredit and it allows you to spread the ~$5k payment over 12 months, interest free. I think if you talk to your parents about how much this affects you, they will probably help you with the cost. It was super hard for me to talk to my parents about this stuff, but they ended up covering half the cost for me. If you decide to have the surgery, I would recommend staying for the first week at your parents place. It helps to have someone to pay attention to all of your meds and when you're supposed to take them / make food for you, because you aren't gunna want to do it (the pain meds make you feel quite drunk), and it's going to be hard to reach upwards to get stuff in the fridge / from cabinets / for the microwave / etc. And also when you have your first shower on the 5th day, you will definitely need help getting the compression vest and bandages off. And not to mention the first post-op visit with the surgeon is on the 8th day, I wouldn't skip that (mine is tomorrow actually).
Good luck man, feel free to ask me any questions or PM any time.