The fluctuation in hormones and the excess of females hormones during puberty leads to gynecomastia. If you are suffering from obesity, the testosterone converts into estrogen. 

Both are different. Gynecomastia is a non-cancerous disorder which increases the male breast. However, pseudogynecomastia looks like gynecomastia but is not one. The body fat gets accumulated on the chest which gives the impression of gynecomastia. 

First things first. Consult with the doctor and let yourself and the doctor know your condition. Ask yourself if the enlargement of breast bothers you physically or otherwise.

Ask a veteran doctor about your case and be practical and realistic. 

Talk to a few surgeons to have a detailed information on the treatment and surgery. Search on Internet and look for doctors with good experience and successful surgeries to his name.