What Grade of Gyno is this?

Looks like a mild case of gynecomastia. I would say grade II maximum

You need a complete history and in person physical examination to grade the Gynecomastia. Ultimate diagnosis of gynecomastia is after the excised tissue is confirmed by the pathologist that is compatible with gynecomastia.

There is no single grading system for Gynecomastia. The significance of a grading system is to assist in determining the best operation for the patient. In short, the first grade is a minor breast enlargement without skin excess. This is treated with liposuction and resection of firm tissue under the nipple if needed. The last grade is marked breast enlargement with significant excess skin and feminization of the chest. This grade requires more extensive surgery with excision of both skin and breast tissue. The middle grades have moderate breast enlargement with or without skin excess. In the middle grades, the type of surgery performed is a balance of the patient’s goals and their acceptance of scars. For example, some patients would accept some residual skin excess to avoid a long visible scar. The next step should be a consultation with a board certified plastic surgeon and learn the options for your individual case.

Actually you need complete physical examination and past history to grading the Gynecomastia. Only from the photos looks like mild grade I-II maximum minor breast enlargement without skin excession and you can treated with chest liposuction that minor surgery without obvious scaring seen.

There is no grading. We go by the amount of tissue, firmness, and the amount of skin and drooping to determine what operation is needed. Most of the times it can be treated with liposuction techniques alone but may require other thing such as mastopexy or skin resections. There are many ABPS certified or eligible surgeons in Austin and you should see one of them for consultation.