Gynecomastia in general is the combination of excess diet resistant fat to the chest combined with glandular tissue, which is a white rubbery substance that develops in the male chest. Sometimes this is caused as a result of unknown changes during puberty, while it can also be caused by steroid use, marijuana use or a number of other hormonal imbalances. For most patients, once this occurs it cannot be completely corrected with exercise. In some cases exercise will actually make the appearance worse because as the chest muscle gets stronger and fuller it pushes the glandular tissue out making the pointiness or feminine appearance of the chest more noticeable. If you feel that your gynecomastia is purely due to excess weight then diet and exercise may be an option. However, for most patients gynecomastia requires a surgical procedure, which combines liposuction of the chest with glandular tissue removal through the areola as the best option. I can perform both of these surgeries through the same small lower areola incisions to minimize scarring and achieve a very masculine appearance to the chest.