Bilateral gynecomastia with small amount of excess breast tissue
Operation: Direct excision of breast tissue, periareolar approach, aided by liposuction. Good contraction of skin

Bilateral gynecomastia with moderate amount of excess breast tissue
Operation: Direct excision of breast tissue, periareolar approach, assisted by liposuction. Good contraction of skin

Bilateral gynecomastia with moderate amount of excess breast tissue
Operation: Direct excision of breast tissue, periareolar approach, assisted by liposuction. Only air contraction of skin leaving small surplus laterally

Unilateral gynecomastia (right) with modest amount of excess breast tissue
Operation: direct excision of breast tissue, periareolar incision, aided by liposuction. Good contraction of skin

Bilateral gynecomastia with moderate excess breast tissue
Operation: Direct excision of breast tissue, periareolar approach, assisted by liposuction. Only fair contraction of skin

Bilateral gynecomastia-moderate to large excess of breast tissue
Operation: Direct excision of gynecomastia with excision of excess skin above areola, periareolar approach, assisted by liposuction. Only fair contraction of skin

Bilateral gynecomastia with moderate excess breast tissue
Operation: Liposuction only. Good skin contraction