If the gynecomastia is deemed to be mostly fat or adipose tissue, then mere liposuction may be recommended. The problem with this procedure is, it often does not remove all of the fat, resulting in an improvement, but not 100% elimination. Secondary touch up surgery may be needed.
The other option is surgical excision of the deeper breast tissue. This is often the only option when the gynecomastia is composed of much fibrous and glandular tissue or when the surgeon needs to submit the specimen for pathologic examination.
Naturally, liposuction usually only involves 2 small incisions per breast, while surgical excision usually results in a larger scar on each breast. The operation is performed as an outpatient, but under a general anaesthesia.
Any post-operative discomfort is managed with oral pain medications. Bruising and swelling is transient and best managed by wearing a compression vest and undergoing a series of massage therapy sessions for Manual Lymphatic Drainage.
This is commonly considered an elective cosmetic procedure. Insurance will only cover in cases when there is concern about the tissue being malignant or occasionally following large weight loss.