There are two important components of gynecomastia or enlarged chest tissue in men. The important thing for your surgeon to determine is how much of the enlargement consists of actual glandular tissue and how much is related to surrounding fat. As every patient has variable amounts of these, there is no set standard and you should seek an evaluation by a qualified plastic surgeon in order to help you make a decision about surgery.
Liposuction can often be used to address the excess fat in the chest but it may not be adequate to deal with the enlarged glandular tissue which often needs to be excised directly, so a combination of the two techniques will probably be required.
Less frequently, there is also a component of excess skin, which may also need to be removed. In this case the end result would involve significantly more scarring so it is very important that your surgeon discuss this with you.
Another important issue relates to the medical aspects of enlarged mammary glands in men. If the enlargement occurs over a relatively short period of time, one needs to consider the cause of such a change. Abnormal increase in hormonal production can lead to enlargement of the chest tissue and this must be evaluated. Your surgeon may want to perform laboratory exams to check hormone levels. Also a good genital exam should be performed if a hormonal cause is suspected.
