Gynecomastia is the most common clinical gynecomastia, accounting for about 60% to 80% of gynecomastia. Gynecomastia occurs mostly in adolescence and is a normal condition, and generally shrinks back to normal around the age of 20. Most of the causes are unknown, but a few may be caused by endocrine disorders. Gynecomastia is generally divided into two categories: primary, which is common in adolescent and older men; and secondary, which is often secondary to certain diseases, such as male hypogonadism, impaired liver function, hemodialysis treatment, and adrenal tumors. Gynecomastia can also be complicated by long-term estrogen therapy or high doses of H2 receptor blockers. Gynecomastia should be examined in detail before treatment in order to detect the primary disease and treat it in a timely manner. There is no need to rush to surgery for those who have enlarged breasts during adolescence. For those whose breasts are too large, cannot be retracted in adulthood, affect their body shape, or have no cause for adult onset, endocrine treatment is ineffective, or those who urgently require cosmetic treatment during puberty can be treated surgically. The traditional surgical procedure is to make a large incision in the upper or lower outer crease of the enlarged breast and remove the enlarged breast tissue after freeing the flap. This method tends to preserve more deep breast tissue and is more traumatic, bleeding, has a high recurrence rate, high infection rate, and poor appearance because of the fear of affecting the blood flow to the areola and nipple. In recent years, we have adopted a minimally invasive method (fat aspiration plus excision) introduced from abroad to treat gynecomastia with satisfactory results. Compared with traditional surgical methods, this method has the following features: (1) the use of anesthesia and swelling technology, less bleeding, less trauma, simple operation, safe; (2) small incision, and the incision overlaps with the edge of the areola, the postoperative scar is not obvious, good appearance; (3) the excision of breast tissue is more complete, postoperative recurrence is not easy; (4) fast healing, less impact on life and work, high patient acceptance.