Excess male breast tissue, known as gynecomastia, affects about one third of the adult male population. The majority of cases do not have a known or defined cause. Some popular causes of gynecomastia are heavy marijuana use, steroids and certain medications. There are several ways to treat this problem depending on the degree of the gynecomastia. Mild cases can be treated with liposuction alone if there is good skin tone in the chest area without sagging skin. Moderated cases of gynecomastia are treated with a combination of liposuction and direct excision of breast tissue through an incision around the nipple/areola. Severe cases will require removal of breast tissue as well as removal of skin from the chest wall. A thorough history and physical exam by an experienced plastic surgeon is needed to determine the best treatment plan for men with gynecomastia.