True gynecomastia is breast tissue in men. It is composed of fat, breast glandular tissue, usually an enlarged areola, and extra skin. To truly treat it, there is a combination of liposuction (usually ultrasonic to help break up the fibrous fat and tighten the skin) and direct excision of breast tissue. If needed, this is accompanied by a reduction in the areola and tightening of the skin.
Most cases I see though are not really gynecomastia. Most are due to fat with little or no breast gland component, which you may hear referred to as “pseudogynecomastia” or “lipomastia”. These are the “man boobs” or “moobs” you see photos of. The good news is fat is easier to treat. In these patients there is less droopiness of the skin and the areola is normal sized. They tend to respond well to simple ultrasonic liposuction.
Adolescent gynecomastia is common and usually temporary. With persistent gynecomastia, you need to also look at other causes such as steroids, liver failure, tumors, genetic disorders, marijuana use, and some medications.
