A pedicled reduction for gynecomastia is an alternative to a free nipple graft procedure when a patient has excess skin and gland/fat. A very thin pedicle of tissue is created around the nipple areola so it can survive, and the superior skin flap is elevated away from the underlying gland. The excess gland is removed, and the skin is brought over the pedicle. The skin is secured to the lower incision and the nipple areola complex is brought out through the skin at an appropriate site. The main disadvantage is it may leave a bit more tissue underneath the skin flap, which could be visible. However, sensation may remain in the nipple areola complex.