Galen introduced the term gynecomastia in the second century AD. He defined gynecomastia as an unnatural increase in the breast fat of males. Although Galen was aware that glandular enlargement of the male breast occurred as a separate entity, he did not consider this gynecomastia.
The first recorded description of a reduction mammaplasty was by Paulas of Aegina in the seventh century AD, who referred to the condition as an "effeminacy of men." Several medical and surgical treatments of gynecomastia were described in the 1800s.
Treatment of gynecomastia has continued to evolve over the ages. Presently, a multifaceted surgical approach is used to optimize correction of the deformity. The fatty component is removed with one or a combination of the variants of liposuction, while the glandular component requires direct excision. The skin is redraped over the underlying structures or, in severe cases, resected. The patient's treatment plan should be crafted to correct the specific problems that are unique to his specific case.1