Summary: Gynecomastia, or persistent enlargement of the male breast, is a common occurrence during early sexual development. Typically, two types of tissue can be identified during this period of growth. Initially, a dense fibrous growth of supporting stroma and breast tissue forms directly under the areola, creating a prominent mass effect. A supporting fibrofatty stroma variably develops around the periphery of the breast, particularly as the body mass index of the patient increases. Treatment is directed at both of these tissue types and includes liposuction contouring along with direct excision of the fibrous subareolar tissue. Resection of redundant skin is performed as needed either immediately or in a delayed fashion. These various modalities can be used either alone or in combination to restore a normal chest wall contour to affected individuals, thus easing the emotional burden that is associated with the condition.