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Why Gynecomastia Surgery is best at DIVINE COSMETIC SURGERY In the initial stages of gynecomastia, there is a slight excess of fat and usually, there is a larger amount of the breast gland just below the nipple which causes the puffiness of the nipple or projection of the nipple. As the situation worsens, the gland becomes bigger and the fat accumulation is larger. This is usually a typical Grade 2 situation. There is usually no excess of skin in Grade 2. The patient usually has complaints that he cannot wear t-shirts or feels embarrassed in taking out his T-shirt in public. We have often seen patients who are not able to realize their complete potential because they are hesitating to approach people and even to express themselves properly because of the embarrassment of a protruding nipple against his shirt Grade 2 Gynecomastia can present as a larger chest with difficulty in wearing t-shirts or fitted shirts, making the patient uncomfortable in public Doing this procedure in Local anesthesia is difficult and painful for the patient. General anesthesia procedure is preferred in order to make it absolutely painless for the patient and to give better results Surgery time is around 45 minutes, with discharge from hospital in 4 hours, and return to work as soon as the next day. Stitches are removed after 7 days.