Before we perform the procedure, we will perform a physical examination in order to properly evaluate your breast tissue. In some cases, tests may be performed in order to confirm your diagnosis. Treatment for gynecomastia may include liposuction, in which breast fat is removed, or mastectomy, a surgery in which the breast gland tissue is removed. Depending on the findings from the clinical examination and ultrasound assessment, your doctor will either recommend liposuction to remove fat tissue, an excision (or surgical removal) of glandular tissue, or a combination of both of these treatments. In the case of liposuction, your doctor will insert a narrow tube through tiny incisions in order to loosen and remove excess fat. The fat is suctioned out of the body. If your doctor decides that glandular breast tissue and skin needs to be removed from the breast area, excision techniques will be used. In some cases, the size of the areola will be decreased and the nipple may be repositioned.