The female breast is a functional organ and one of the hallmarks of a woman’s physical beauty. However, some male breasts can also become enlarged and even look like female breasts, which is medically known as gynecomastia. Patients present with enlarged breasts, sometimes with localized pain or milk-like discharge. In addition to affecting their appearance, more patients feel embarrassed and depressed and have a strong desire for treatment. Gynecomastia mostly occurs in men during puberty or old age. Its pathogenesis is related to hormonal endocrine disorders, such as increased estrogen levels or increased sensitivity of estrogen receptors in breast tissue, and androgen receptor defects. The types of pathogenesis are classified as primary and secondary. The former includes adolescent gynecomastia and geriatric gynecomastia, which is characterized by the formation of a 2-4 cm lump under the areola on one side or both sides, and mostly resolves naturally within 1-2 years; the latter includes hypogonadism, testicular tumors, hyperthyroidism, liver function abnormalities, and long-term use of certain drugs. The treatment of gynecomastia hypertrophy should vary from person to person. The first consideration is conservative treatment: for primary gynecomastia, most will subside naturally and no special treatment is needed; for secondary gynecomastia, treatment should be directed at the cause. The second option is surgery: for those with significant pain, excessive breast enlargement or persistent non-receding, surgical excision can be performed to remove the enlarged glandular tissue through an arched incision in the areola, but retain 0.51 cm of glandular tissue under the nipple to support the nipple, which can avoid postoperative nipple depression and restore good breast shape.