Which grade of gynecomastia is this? Does it required liposuction + gland removal or only removal is sufficient?? (photo)

I am suffering from gynecomastia , does surgery to treat my gyno require liposuction + gland removal or only gland removal is sufficient?

Doctor Answers 13

The Various Types of Gynecomastia & Their Treatment

There are different types of #gynecomastia. Normal Gynecomastia is usually apparent in boy between the ages of 12 to 15 years old and older men 65 years old or more who experience a drop in their testosterone levels. This type of Gynecomastia takes about one to two years to regress on its own.

Pure Glandular Gynecomastia is seen more commonly in body builders and is caused by steroid use. Surgical removal of the gland is required for treatment.
Adult Gynecomastia – Fat deposits are apparent in the glandular tissue. This type of gynecomastia is the most common. Doctors may recommend surgery for treatment of the condition.
Adolescent Gynecomastia is hereditary and usually appears in 30% to 60% of boys between the ages of nine to fourteen. Many cases of adolescent gynecomastia resolve on its own as the boy grows into adulthood. Some may choose to undergo surgery to correct the situation, this usually happens at the age of 18 or above. In severe cases in young boys, the physician and child development specialists will need to speak to the parents regarding the severity of the gynecomastia and if surgery is an option before the age of 18.
Assymetric or Unilateral Gynecomastia appears in either one or both breasts at different degrees. In many cases one breast appears larger than the other. Surgery is a common treatment for this type of gynecomastia.
Pseudo-Gynecomastia is composed of adipose tissue instead of glandular tissue. This type of gynecomastia can be treated with diet, liposuction or surgery
Severe Gynecomastia commonly affects those who have lost skin elasticity at an older age and those who have been obese or overweight at one point in their life and lost weight may have saggy skin and breasts that are severely enlarged. Surgery is the recommended treatment for severe gynecomastia.

The excision technique is used on cases of #gynecomastia where excess skin and glandular breast tissue must be removed and the areola or nipple needs reduction and repositioning to create a natural looking appearance. The incision patterns are determined by the specific condition of the patient. The doctor will recommend this procedure which combines the liposuction technique and excision technique to create a natural look. Patients are given specific instructions for the recovery period. 

Men who suffer from large #areolas may notice that after breast surgery, the skin of the chest muscles will tighten, causing the areolas to tighten and diminish in size. This is a result of the removal of glandular and/or adipose tissue.

The most important decision to be made before performing any surgical procedure is determining whether you are an ideal #candidate.

Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews


It is important to examine, but it appears from your pictures that you may have true, but fairly mild,  gynecomastia. If so, this represents glandular tissue and probably will change very little with exercise or weight changes. It is not usually a serious medical condition, but if you are concerned about the appearance I would recommend that you seek consultation with a board certified plastic surgeon, as surgery is usually necessary (and effective) to masculinize the chest shape.

Jeffrey D. Wagner, MD
Indianapolis Plastic Surgeon
4.9 out of 5 stars 26 reviews


Thank you for the photos and question and whether liposuction alone or excision would be the best solution for you will require an examination and possibly mammograms so see some experts in your area

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 61 reviews

Moderate gynecomastia

You have moderate gynecomastia making you a perfect candidate for gynecomastia repair which requires direct excsion of discoid tissue and liposuction of the peripery so that you have a smooth contour. Please see examples below.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 68 reviews


With the photo it is impossible to be totally accurate.I would suspect you have both glandular and fat present.Optimal treatment would require both be addressed.

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.6 out of 5 stars 14 reviews


Many people with gynecomastia also have fat around the lower part of their waist/"muffin top" area. These patients need liposuction for best results. Over weight people also need liposuction for best results. Most people need both liposuction and direct excision through a small, small scar. Some patients only need direct excision if all they have is a firm bit of tissue only directly under the areola/nipple area. You will need to have an examination since it's a bit hard to tell from your photos. I hope this helps!!

Angela Keen, MD
Salt Lake City Plastic Surgeon
4.8 out of 5 stars 32 reviews


You need to be seen and examined in person to know what would be best for you. Most of the time I use a combination of liposuction and then gland excision, but I need to examine the patient to know for sure.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews


Your chest would have to be examined to determine if you have more glandular or fatty tissue.  You might need direct excision of tissue.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Which grade of gynecomastia is this? Does it required liposuction + gland removal or only removal is sufficient??

Thank you for the question and pictures. Accurate diagnosis would necessitate physical examination. It IS important to differentiate gynecomastia ( excess breast tissue) from lipomastia ( otherwise known as pseudo-gynecomastia or excess adipose tissue of chest wall). Treatment will differ depending on diagnosis. In most cases, gynecomastia is treated with resection of the excess breast tissue; peripheral chest liposuction may also be helpful.
My best suggestion: seek consultation with board-certified plastic surgeons who can demonstrate significant experience achieving the types of outcomes you will be pleased with.
You may find the attached link helpful to you as you learn more. Best

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

Gynecomastia diagnosis

Yes, you do have moderate gynecomastia, which most likely includes some ratio of gland and fat.

In my experience of thousands of gynecomastia operation, the vast majority require both lipo and gland excision in order to achieve a flat, trim and contoured chest.

The procedure typically takes about 90 minutes or less and is performed on an outpatient basis in my private OR suite under twilight anesthesia.

Be sure to look for a plastic surgeon who has considerable experience in gynecomastia surgery.

Good luck!

Elliot Jacobs, MD, FACS
New York City

Elliot W. Jacobs, MD
New York Plastic Surgeon
4.5 out of 5 stars 35 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.