Gynecomastia surgery, also known as male breast reduction surgery or reduction mammaplasty, is a procedure that aims to correct enlarged male breasts. This condition can be caused by an imbalance of estrogen and testosterone ratios, which can be due to certain recreational drugs and prescription medications. The procedure involves removing excess fat, glandular tissue, and skin from the breasts. There are different techniques used for the procedure, including liposuction, direct excision of excess breast tissue and skin, or a combination of both. The ideal technique depends on the severity of the gynecomastia and the amount of excess fatty tissue versus glandular tissue and skin laxity. The procedure is usually performed under general anesthesia or local anesthesia with sedation, and it is typically an outpatient procedure. Recovery time varies depending on the technique used, but most patients can return to work and exercise within a week. As with any surgery, there are risks involved, including bruising, bleeding, fluid collections, contour irregularities, loss of nipple skin, visible scarring, numbness of the nipples, inverted nipples, loose breast skin, and asymmetries. It is important to choose a board-certified plastic surgeon who can perform a proper physical exam of the breasts to confirm gynecomastia and rule out the suspicion for male breast cancer. Male breast reduction surgery has a very high satisfaction rate and has been shown to improve patients’ quality of life.