Mild gynecomastia or fat? Surgery?

[DQuil]

I've had puffy nipples ever since I was 13. I struggled with obesity then (33% BF). But now I'm 19 years old and just under 11% BF. Still, It's hard to wear t-shirts without them sticking out. I am skinny-fat, and I am pretty sure I might have had some hormone imbalances as a teen, since I have larger hips than most men.
If this requires surgery, how much should I expect to pay? I have heard that being filmed lowers the price. (Which I am okay with). I am also willing to do the surgery under local anesthesia.
Note: I live in GA, US. I am also Korean.

[George Pope, M.D.]

You mention possible hormone imbalance.  Was that ever evaluated by your pediatrician?  It may be worth looking into prior to surgery since you're very young and you mention abnormal distribution of fat in the hip area.
You appear to have a mild case of gynecomastia, with the larger areola diameter most likely aggravated by breast tissue beneath it.  You'll most likely need both gland (breast tissue) removal and liposuction. Try to find a board certified plastic surgeon in your area who does a lot of gynecomastia surgery.
Best of luck-
Dr. Pope, MD