Gynecomastia, also known as male gynecomastia, has a prevalence of about 30% and occurs mostly in men during puberty or old age. The pathogenesis is related to the imbalance of various endocrine hormones in the body. The pathogenesis of gynecomastia is related to various endocrine hormone disorders in the body, such as increased or relatively increased estrogen levels or increased sensitivity of estrogen receptors in breast tissue to estrogen, and androgen receptor defects. Gynecomastia can be on one or both sides. Although genetics, medical disorders and some medications were once thought to be associated with gynecomastia, no exact cause could be found in most cases. The incidence has been on the rise in recent years. The following treatment options are available for gynecomastia. I. Watchful waiting: The onset of gynecomastia in adolescents not older than 12-18 months is reviewed within 6 months after a physical examination, including genitalia. Drug-induced gynecomastia is re-evaluated after a period of discontinuation of medication. II. Medication: For persistent gynecomastia, three separate types of medications are available Androgens: for gynecomastia caused by hypogonadism Dihydrotestosterone: used for secondary gynecomastia Danazol: can significantly reduce breast pain and size. Surgery: If medication has not worked for a period of time or if the breast has been enlarged for many years and has become an extremely annoying mental burden for the patient, or if larger gynecomastia or cancer is suspected, surgical removal of the enlarged breast gland tissue is required. The indications include: ①Males with breast development at the end of puberty or after puberty, with breast diameter >4 cm, where medication is ineffective; ②Seriously affecting the aesthetics; ③Suspected malignant changes. Different methods are used for gynecomastia according to the degree of glandular and fat and skin laxity. 1.Simple breast fat aspiration: the incision is about 5mm long and can be done without sutures or without removing stitches for fatty patients. This method has the most concealed scar and faster recovery. 2.Simple glandular excision: the incision is about 75px long, located under the areola, and is suitable for glandular-based type. 3.Fat aspiration combined with glandular excision: the incision is about 1 to 50 px long and is suitable for mixed types, most gynecomastia can use this technique. Regardless of the incision, the PULL-THROUG TECHNIQUE requires a smaller incision, less postoperative scarring, and is effective in preventing sunken deformities in the areola area.