Only gland ( breast tissue) is enlarged along with some fat deposit. No skin sagging is present. Diet/ exercise or medicines cannot correct Gynaecomastia. Only treatment is surgery which was done for this gentleman. Gland was cut out and removed along with liposuction to refine the result. Gods news .. it does not come back! However if one uses anabolic steroids ( to build muscle) then Gynaecomastia can come back. Gynaecomastia surgery gives a gratifying outcome in majority of patients. Please note results may vary. Will talk about other grades of Gynaecomastia in future posts.