Abstract
Gynecomastia, excess development of the male breast, is a common deformity encountered by plastic surgeons. It is the most common breast alteration in males, commonly developing without a pathologic basis during periods of physiologic change such as infancy, puberty, and old age. It may accompany a wide variety of systemic and metabolic diseases, and it may be drug induced. Given the number of pathophysiologic mechanisms, detailed presurgical workup is essential prior to determining whether surgical management is appropriate. This chapter highlights different surgical techniques performed in our practice, along with standardized preoperative evaluation and postoperative care. We believe that a dynamic approach to patients with gynecomastia decreases common complications and increases patient satisfaction in various degrees of gynecomastia. This chapter includes some “tricks” we use during our markings, preoperative steps, and intraoperative approaches that help us optimize patient safety, while maintaining operative efficacy and improving aesthetic outcomes in gynecomastia.