What are my choices in limiting it or eliminating it. I am concerned about it because i am extremely self conscious about taking my shirt off, wearing tight shirts, etc. I notice that when my nipples are erect, the gynecomastia looks less prominent. Also i usually wear a white, tight tank top tee shirt under all my shirts because this also makes the gynecomastia less prominent. I am a Board Certified Plastic Surgeon.
Surgical options depend on the extent of the problem.
Small amounts of breast tissue can be excised from incisions around the areola. When the tissue excess involves a great deal of skin and underlying tissue, breast reduction with larger incisions may be required. You can see some of the types of incisions used for larger breast on the short scar mastopexy page . Major male breast excess reduction surgery has some of the same types of incisions necessary. Most gynecomastia surgery is not this extensive.