In recent years, there has been a gradual increase in the number of patients with gynecomastia, which is closely related to the changes in the current living environment, radiation pollution, dietary structure and personal habits. For gynecomastia, there are mainly conservative treatment and surgical treatment.1. Conservative treatment: mainly refers to the early stage of the disease, when mammary gland development is not obvious, oral androgenic drugs are given. However, most patients do not pay much attention to the early stage, and some patients are not sensitive to conservative treatment, the treatment effect is not obvious, in this case, you need to choose the surgical treatment. 2.Surgical treatment: At present, there are two main surgical treatments for gynecomastia, one is the traditional surgical excision and the other is the minimally invasive hidden scar endoscopic surgery. What kind of patients need to undergo surgical treatment: 1, breast diameter greater than 3-4cm, and 24 months continue not to recede; 2, there are obvious symptoms of breast pain; 3, suspected breast cancer; 4, drug conservative treatment is ineffective; 5, affect the aesthetics or the patient’s fear of lesion cancer. The traditional surgical approach mainly uses an incision on the surface of the breast in front of the chest, which is more suitable for patients with gynecomastia of grade 2 or less. For patients with grade 2 or higher, traditional surgery is more likely to result in complications such as subcutaneous hematoma, fluid collection, nipple necrosis, and nipple sensory disturbance after surgery. Minimally invasive endoscopic surgery is a technically demanding surgical procedure that uses endoscopic surgical instruments and surgical techniques to perform complete removal of the developing male breast. Although its relative cost is higher, the advantages of the procedure are also very obvious. Minimally invasive endoscopic surgery is suitable for: 1) those with clear glandular components in the breast found by preoperative ultrasound; 2) those with a breast diameter greater than 4 cm, graded 2 or more and lasting more than one year; 3) those for whom anti-estrogen therapy has been ineffective for more than 3 months; 4) those with no history of surgery or major trauma to the breast surface for better results. Minimally invasive endoscopic surgery not only avoids many of the complications of traditional surgery, but also has more satisfactory results in terms of cosmetic appearance. In the figure below, A is the postoperative appearance of traditional surgery, while B is the postoperative result of endoscopic surgery.