Gynecomastia, assessed before any surgical route.

Enlarged male chest tissue falls into three broad types: glandular (true breast-gland tissue growth, often hormone-driven), fatty (fat deposit without gland growth, closer to a body-contouring concern), or mixed. The surgical approach follows the type. Fatty gynecomastia typically responds to liposuction alone. Glandular tissue does not reduce with liposuction and instead needs direct excision. Mixed cases usually combine both techniques in the same procedure. Some cases also have an underlying medical or medication-related cause, which is why assessment, sometimes including bloodwork, comes before any surgical plan is proposed.