الفهرس 
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Abstract
Gynecomastia is a benign condition refers to enlargement of the male breast either due to proliferation of ductal, stromal or fatty tissue.
It affects about 30-60 % of newborn infants and about 30-65 % of adolescents and old age.
It occurs due to imbalance between serum levels of estrogens and androgens in the form of increasing levels of estrogens or decreasing levels of androgens.
Also, it may be due to a defect in androgen receptors that become insensitive to normal levels of circulating androgens.
The causes may be idiopathic, congenital, physiological, drug induced, oncological and systemic diseases.
There are several classifications for gynecomastia that have been used but the most commonly used is Simon classification.
Proper diagnosis of gynecomastia is achieved by adequate history taking, general, local examination and laboratory investigations.
Treatment is divided into reassurance and follow up, treatment of the cause, pharmacotherapy and surgical therapy.
It is either liposuction alone, subcutaneous mastectomy with or without skin excision and a combination of liposuction and surgical excision.
There are many methods of liposuction as conventional, power assisted, ultrasound assisted and laser assisted liposuction.
Subcutaneous mastectomy may be with or without skin excision. Approaches of mastectomy without skin excision may be periareolar, circumareolar, perithelial, intra-areolar, inframammary and axillary.
Approaches of skin excision may be circumareolar, inverted-T, le jour mastopexy and free nipple areolar graft.
The surgical management of high grades gynecomastia is considered a problematic issue as liposuction and conventional subcutaneous mastectomy without skin excision are not sufficient in most cases and need another session for redundant skin excision.
So, in our study statistics shows to some extent the preference of peripheral liposuction with central disk excision over subcutaneous mastectomy round block technique in treatment of gynecomastia according to incidence of hematoma, wound dehiscence, scar quality and patient satisfaction.