True one-sided gynecomastia is rare. Careful consideration must be done to consider other diagnoses, such as a tumor. Once that possibility is removed, then a decision must be made about treatment. Often, one side is much larger than the other — but both sides are frequently affected. In the past, only one side may have been treated — and the patient then returned asking for treatment of the now-larger “normal” side as well.
Therefore, careful examination of both breasts is performed and surgery on both breasts considered if need be. If this smaller amount of gynecomastia is not addressed at surgery, then the end result may be that the operated side will look completely normal and the un-operated side may then be objectionable. It is extremely difficult to operate on the larger side and reduce it just enough to match the other side. Thus, appropriate surgery should be done to optimize both sides at the same time.
