Gynecomastia refers to the abnormal growth and development of periductal tissue and adipose tissue in men, with an incidence of 32% to 65%. It is generally believed that the cause is due to a relative or absolute increase in estrogen or a decrease in androgens. Treatment should be based on finding the cause of the disease, and medication such as tamoxifen, toremifene and Chinese herbal medicine can be used to achieve good results. After removing the cause, if the effect of medication is not obvious and affects the life and appearance of the patient, surgery can be considered. Clinical efficacy: cured: breast lumps and pain disappeared; improved: breast lumps shrunk and pain reduced or disappeared; not cured: no change in breast lumps and pain. Aesthetic effect: The standard evaluation of aesthetic effect 3 months after surgery, mainly assesses whether the postoperative breast contour is flat and symmetrical, whether the scars are obvious and whether the nipple areola feels abnormal. A good cosmetic result is a flat and symmetrical postoperative chest and an inconspicuous incision scar. Surgical procedures for gynecomastia can be broadly divided into three categories: liposuction, open excision, and liposuction plus open excision. The liposuction method is mainly used for gynecomastia with mainly fatty tissue proliferation. The open excision method is a small incision along the areola with a small amount of tissue removed, and is generally feasible for gynecomastia below grade IIA. However, for patients with more hyperplastic glands and excess skin (Class IIB-III), excessive pulling of the hook and heat transfer by the electric knife during surgery may lead to postoperative scar formation and skin folds, which may affect postoperative aesthetics. Liposuction can fully remove tissues; using combined incision, not only the incision is small and hidden, postoperative scar is not obvious, good appearance, in line with the cosmetic requirements; and can fully expose the incision while removing excess skin, expand the operator’s field of vision, reduce excessive intraoperative traction, facilitate operation, convenient hemostasis, to achieve the ideal surgical results. The key to successful surgery is: ①Mastering the indications and timing of surgery: Generally, surgery should be performed when the breast development does not subside on its own after 2 years. ②Strict preoperative preparation, communication and education, and design: mark the basal line of the breast, the double circumferential incision line and the dermal mammary tip area of the nipple areola in the standing position. ③Intraoperative operation : Anesthetic swelling solution is injected to make the whole breast area swollen and augmented, but it should be noted that the total amount of lidocaine should not exceed 7mg /kg, and the concentration of lidocaine can be reduced if more is needed. The flap should be separated deeply along the subcutaneous tissue, and the upper dermal mammary flap outside the nipple and areola should be of uniform thickness, and the rest of the breast should be completely excised. After healing, the incision still needs to be wrapped with an elastic bandage or compression garment for 6 to 9 months to prevent scarring of the incision. In conclusion, for patients with moderate-to-severe gynecomastia, post-liposuction + combined incision treatment is a surgical procedure with precise efficacy, easy operation and satisfactory cosmetic effect, which does not require special instruments and is easy to master.