Although gynecomastia treatment has evolved a lot but there are still many limitations to a perfect management plan specially for high grade gynaecomastia. Different methods have been applied to approach excess skin in these patients. All these methods result in visible scars which are cumbersome to patients as well as surgeons treating them. Managing these problems can help patients and surgeons greatly to increase their confidence. Objective: The authors describe a useful technique of dealing with excess gland and skin in grade III gynecomastia without leaving many unsightly scars. Methods: The study was performed on gynaecomastia patients. The study was conducted from January 2014 to December 2019 and 45 patients were included who underwent Liposuction and glandular excision followed by compression garments application. Outcome of the patients in terms of complications and aesthetic results was noted. Aesthetic Outcome was measured by the Surgeon ranging from O (Poor) to 5 (Excellent). Patient Satisfaction was also graded on a Scale from O (Unsatisfied) to 5 (highly satisfied). Results: All patients were adults, ages 16 to 55. Seroma formation was observed in 15 patients. It was managed with simple aspiration. Six patients complained of Rippling and twelve patients complained of minor skin epidermolysis. Complain of skin or nipple necrosis or saucer deformity was not observed in any patient. Average patient satisfaction score was 4.75 and the surgeon observed score was 4.3 7. Conclusion: Gynecomastia Grade III can be effectively treated with liposuction and gland excision preserving the skin in selected patients
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