GYNECOMASTIA is enlargement of the male breast.  We see it in 10% of men.  Men are often very embarrassed by this and will not take their shirts off at the pool or beach.  Gynecomastia can be due to glandular enlargement or fat accumulation.  We see 2 different times this develops.  One is at puberty and this is mostly glandular enlargement from high hormone levels at this age.  The glandular enlargement is similar but not identical to a woman’s breast.  The second time we see gynecomastia is as men mature (sometimes called “man boobs” or “moobs”)and this is mostly fat with possibly some gland.  It can look worse as the skin loosens with age.  If it is mostly glandular we usually need to excise the tissue with a small incision below the nipple.  With mostly fat we can treat it by liposuction which has tiny incisions.  If there is a lot of skin looseness we may tighten the skin which requires more incisions.  Men that have this surgery are usually very grateful and find it changes their life.