The gold standard treatment for gynecomastia is surgery. Medical treatment with hormones and medications (prescription, over the counter or from the Internet) will not effectively treat established gynecomastia. Self treatment with diet and exercise will not cure your gynecomastia as it is resistant to both. It is disappointing that you cannot fix yourself as most men wish they could.
Surgical treatment of gynecomastia is straightforward, but requires great skill and artistry. Every case is different to some degree, challenging your surgeon to make appropriate adjustments and modifications so the best result is realized.
The primary focus is on the reduction of excess volume in the chest area. This is usually performed with a combination of liposuction and glandular tissue removal. The skin retracts impressively well after the removal of excessive chest tissue, even in patients who actually have saggy skin, which makes the need for skin removal uncommon. If loose skin persists after treatment, it is always possible and even advisable to contour the excess skin as a secondary procedure.