<s>[INST] Hi doctor, I am a 38-year-old male, 174 cm tall and weight is 73 kg. I have been having puffed up nipples since long and can feel slight hardness under the nipple surface. It is painless and there is no discharge. I suspect gynecomastia. I can provide you photographs. Need your advice on treatment. [/INST] Hi. You have bilateral grade II gynecomastia. Medical treatment, diet and exercise cannot reverse it. The correction will require liposuction with gland excision. It is a day care procedure. You can get discharged on the same day. </s>