How to Choose the Right Type of Gynecomastia Surgery or Treatment

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Want to get rid of man boobs, but not sure if there are any treatments you should consider before consulting with a plastic surgeon about gynecomastia surgery? As a Board-Certified Plastic Surgeon and a  member of the American Society of Plastic Surgeons (ASAPS),  I am a recognized expert in the field of gynecomastia surgical procedures. is the largest international forum providing unprecedented resources about gynecomastia treatments and surgical options. Gynecomastia causes excess growth of glandular tissue, which can create a feminized appearance of the chest in men. The type of gynecomastia treatment or gynecomastia surgery that is most appropriate will depend on various factors, including patient preference, the gynecomastia grade, and individual physiology.  

Here is a guide to the types of gynecomastia, gynecomastia treatment, and gynecomastia surgical options.


  • How Do I Know if I Need Gynecomastia Surgery?
  • What Are the Grades of Gynecomastia 
  • How to Reduce Gynecomastia Symptoms With Exercise and Diet
  • Do Medications for Gynecomastia Work?
  • Types of Gynecomastia Surgery 
  • How to Choose a Gynecomastia Surgeon

How Do I Know if I Need Gynecomastia Surgery?

True gynecomastia is caused by excess glandular tissue and in some cases breast fat. Pseudogynecomastia is only a result of breast fat which may be reduced with diet and exercise. Depending on age and the amount of weight lost, men with pseudogynecomastia may still require surgery, to remove excess skin and stubborn breast fat. When excess glandular tissue is causing gynecomastia symptoms, surgery is the fastest way to permanently resolve gynecomastia and get rid of man boobs. 

The first step to determine if gynecomastia surgery is required is to receive a gynecomastia diagnosis from a specialist. Normally a physical examination performed by a plastic surgery who specializes in gynecomastia surgery is sufficient to determine the type, grade, and appropriate treatment options. Alternatively, an endocrinologist or doctor can take blood tests to check for other health causes for gynecomastia symptoms.  

What Are the Grades of Gynecomastia?

Gynecomastia is categorized by the American Association of Plastic Surgeons into 4 grades. Grades of gynecomastia are based on the degree of glandular tissue and breast fat, excess skin, and the overall size of the chest. Here is a quick summary of the grades and symptoms.

  • Grade 1 – This is the least noticeable type of gynecomastia, symptoms are typically a small amount of increased chest size with no excess skin. Additionally, the nipple area often looks puffy or swollen. 
  • Grade 2 – Symptoms are more noticeable with a greater degree of glandular tissue and breast fat which gives a feminized appearance. There may be a very slight crease due to excess skin.
  • Grade 3 – The chest is very feminized giving the appearance of small to moderate-sized breasts. There is a significant amount of glandular tissue, areolas may be stretched and look larger. The breast crease is more significant with a greater degree of excess skin.
  • Grade 4 – This is the most extreme grade of gynecomastia and gives the appearance of feminine breasts with a deep crease. There will be a substantial amount of glandular tissue, breast fat, and excess skin.

How to Reduce Gynecomastia Symptoms With Exercise and Diet

Exercise and diet to strip fat and build lean muscle may help to reduce symptoms of gynecomastia, especially for grade 1 and 2 gynecomastia when breast fat is present. It is important to have realistic expectations and understand that no amount of exercise or any kind of diet will reduce excess glandular tissue. However, it is still worthwhile trying to reduce gynecomastia symptoms prior to gynecomastia surgery. Cardiovascular exercise such as running, swimming, or dancing is essential to burn fat.

Eating a high protein, low-fat diet and avoiding food that may increase estrogen levels may help to reduce gynecomastia symptoms. Diet with a proper exercise regime is also key to stripping fat and building lean muscle.  A nutritious diet will also give you the energy to exercise, help muscle repair faster following weight lifting, and improve general physical and mental health. 

Do Medications for Gynecomastia Work?

There are no FDA-approved medications for gynecomastia, however various medications can be prescribed “off counter” for the treatment of gynecomastia. These include Tamoxifen, Clomiphene, and Anastozole, the results are questionable and gynecomastia symptoms can return when medication is stopped. As with all medications, they may induce side effects which include nausea, skin rash, hair loss, and erectile dysfunction. Pills that you can buy without a prescription are sold as supplements. They will not reduce glandular tissue and can not change hormonal balance, although they may help burn fat faster when combined with the correct diet and exercise.

Types of Gynecomastia Surgery 

There are different techniques used depending on the grade of gynecomastia and if the patient is willing to have two procedures. Here are the four most common gynecomastia surgery procedures.

1. “Pull through technique” – This is an advanced procedure that only needs a very small 5mm incision. This technique is normally only suitable for grade 1 gynecomastia.

2. Webster method – This is the most common procedure, the incisions are made around the edge of the areola and are difficult to detect once healed. This technique is suitable for grade 2 and some grade 3 gynecomastia symptoms.

3. Two-stage procedure – This starts with the webster method and approximately 6 months later a peri-areola lift is performed, to remove excess skin. All incisions are made around the edge of the areola and are well concealed by the difference in color between areola skin and chest skin. This procedure is suitable for grade 3 and less severe grade 4 gynecomastia symptoms.

4. Double incision mastectomy – This is the only procedure that will remove all excess skin and provide an instant result for grade 3 and almost all grade 4 gynecomastia cases. This procedure is less desirable due to the scars that will be evident on the chest area. 

How to Choose a Gynecomastia Surgeon

When deciding to have gynecomastia surgery the most important decision is the surgeon who will perform the procedure. In the USA any surgeon can practice plastic surgery. This means they can legally advertise themselves as a cosmetic surgeon, without any specialist knowledge of plastic and cosmetic surgery techniques. This is why it is vital to choose a board-certified, specialist plastic surgeon. Not only will plastic surgeons have more experience, they are also more likely to use high standards of surgical facilities and have well-trained and qualified nursing and support staff. 

I hope you find the right solution for your gynecomastia type and grade with this advice. Please comment if you have had gynecomastia surgery or if you decide to have a procedure further to reading this article.