Gynecomastia can be divided into physiological breast enlargement and pathological breast enlargement. Among them, the cause of physiological breast enlargement is unknown, and most people believe that it is related to endocrine imbalance or imbalance of estrogen/androgen ratio and high sensitivity of breast tissue to estrogen, which can be subdivided into neonatal breast enlargement, adolescent breast enlargement and geriatric breast development disorder. Pathological breast enlargement is mostly associated with endocrine hormone imbalance or hormone-related changes due to lesions in the testes, adrenal cortex, pituitary gland, liver, kidneys, etc. However, most patients do not have a clear clinical cause and are considered to have idiopathic disease. Most patients can be relieved to some extent by sex hormone-related medication. In some cases, due to the large size of the breast, the long duration of the disease, the lack of efficacy of medication, and the serious psychological burden that the enlarged breast imposes on the patient, such patients require surgical treatment. (1) those with breast diameter >4 cm that does not subside for 24 months; (2) those with symptoms; (3) those with suspected malignant changes; (4) those for whom drug therapy is ineffective; (5) those who affect aesthetics or whose patients fear cancer and request surgery. In our clinical work, we have found that although most physiological gynecomastia during puberty can subside on its own, there are other patients who need surgery when their gynecomastia has a long course and the hyperplastic glands can be replaced by fibrous tissue and vitreous lesions, and even if the cause is removed or treated with sex hormone-related drugs, the developed breast cannot subside completely. The standard procedure for male breast development is simple mastectomy, which usually leaves a more obvious scar on the surface of the breast and seriously affects the aesthetics; on the other hand, if an areolar incision is made for aesthetic reasons, the incision is bound to destroy part of the vascular network around the nipple areola, affecting the blood supply to the nipple areola and increasing the chance of nipple areolar necrosis. Due to these defects, some patients are worried about the results of the surgery or even refuse to undergo the surgery, which is a contradictory psychological situation that is bound to cause serious harm to the patient’s body and mind. Therefore, it is important to design a minimally invasive and cosmetically satisfactory surgical approach for gynecomastia. The lumpectomy of subcutaneous breast glandular excision establishes the manipulation space on the basis of lipolysis and liposuction, which can be applied to various degrees of gynecomastia, and the excision of the glandular body can avoid incision scars on the surface of the breast, and we have recently completed the treatment of several patients with good cosmetic results using this method.