Surgery is the gold standard of treatment. Liposuction and removal of the retroareolar breast tissue has been an extremely effective method to recountour and enhance the male chest. This day surgery has been beneficial to countless numbers of men afflicted with gynecomastia in our practice in Dallas.  Patients have flown in from all over the world including Canada, Mexico, Europe, India, Dubai, Saudi Arabia, Argentina and Central America to have the procedure done in Dallas. Patients often undergo sedation and are not put under a full general anesthetic.  This minimizes the risk of anesthesia while allowing the patient a twilight anesthesia where they are asleep without the need for intubation.  In the majority of cases, gynecomastia is caused by genetics and not caused by the actions on the patient.