Since airing a segment on TV many inquiries are coming in about gynecomastia or male breasts. Gynecomastia can start at puberty without known cause. It can start later in life if one uses steroids, or certain diuretics or uses marijuana. Some develop it after massive weight gain. If there is no underlying cause for it which can be eliminated by other stopping the drugs that cause it or the hormonal imbalance that may cause it then the only option is to remove it surgically. What procedure is used depends on the severity of the condition. If the gynecomastia consists of just fat in a young person with elastic skin then one can just suction with good results. If the gynecomastia in a young person with good skin tone has a bit of breast tissue it may need to be excised at the same surgery as the suction procedure. The scar can be well hidden in the areola border. If the person is older and the skin is quite stretched out and has been for a while then skin excision must accompany the removal of the breast tissue and that leaves scars that unless the person has lots of hair on the chest may not be so attractive and one may need to consider what is better for that person. Scars which are quite noticeable or the gynecomastia skin remaining as a fold after the contensts are removed. The removal of the breast tissue and fat will make the fold smaller but the fold will remain unless removed. Not unlike breast reduction in women. It is of note that breast tissue of a male must also be sent to pathology. Males can also develop cancer of the breast altho the incidence of that is much smaller than in females. The surgery itself is an outpatient procedure done with sedation and local anesthesia. After the procedure the patient wears a snug velcro vest to keep pressure on the area. The sutures often dissolve by themselves. Bruising occurs for about 1-2 weeks depending on the person and the extent of the surgery. A person should refrain from vigorous activity like exercise or heavy lifting for about 6 weeks. The pain postoperatively is minimal and is easily managed with oral pain pills. Antibiotics are usually given prophylactically. If the skin envelope is not extensive the gynecomastia surgery results in few scars and the patient is usually extremely happy. If one has a severe case of skin redundancy then the scars postoperatively must be considered. One does not want to remove one embarrassing condition and substitute for another. Best done at a younger age to avoid the unnecessary scars as then the skin still has a nice elasticity which will help in shrinking down the skin after the breast tissue and fat removal.