Male breast reduction surgery can be done totally under local anesthesia by the tumescent technique. It is also called ‘AWAKE SURGERY’. Patient remains awake and conversant while the surgery is going on. There is no pain or discomfort throughout the surgery. Surprisingly, when this surgery is done under tumescent local anesthesia, there is virtually no pain even after the effect of anesthesia wears off! An operation under tumescent local anesthesia (AWAKE-SURGERY) is the safest and best way of getting rid of male breasts. Patient remains alert, fully mobile and can go home immediately after surgery. Tumescent technique of local anesthesia gives exceptional patient safety. All boys get a completely normal looking flat chest. The residual large envelope of skin shrinks completely over a period of time. It does not ‘sag’ in the post-op period. There is really no need to excise the skin at the time of primary surgery.