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Gynecomastia Grading System

Posted on Friday, April 5th, 2013 by Dr. Babak Dadvand

In medicine, we use grading systems to be able to communicate how severe a condition is as well as what the potential best treatment is for that grade. Gynecomastia is no different and yes, there is a grading system for gynecomastia as well. There are several grading systems for gynecomastia. However, the American Society of Plastic Surgeons has adopted the following system which is clear and descriptive.


Grade 1: Small breast enlargement with localized increase in tissue around the areola

Grade 2: Moderate breast enlargement exceeding areola boundaries with no skin excess

Grade 3: Moderate breast enlargement exceeding areola boundaries with minor skin excess

Grade 4: Marked breast enlargement with significant skin excess and feminization of the breast


For Grades 1-3, no skin resection needs to be performed. However, for Grade 4, not only does the excess tissue has to be removed, but so does the excess skin.  Although this leads to more incisions, it also creates a significantly better contour.

To learn more about gynecomastia and to view before and after pictures visit my website at drdadvandplasticsurgery.com.

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