For the San Francisco Bay Area man, in order to remove male breast tissue and fat during male breast reduction surgery, an incision is made at the bottom half of the areola, between the darker and lighter skin. When it heals the gynecomastia scar is almost invisible. Chest hair can also help in hiding the incision. The healing process can take up to 6 months to a year.
I recommend silicone sheeting about 10 days after the gynecomastia scars are healed. Silicone sheeting helps soften and lighten the color of the gynecomastia scar. I also do a tiny incision in the armpit for the liposuction cannula and for the drain.
My San Francisco patients let me know that the tiny scar left by the drain under the arm was a point of concern, now by a new technique I place it high up in the armpit toward the back, most of my patients have a hard time finding it.
Depending on the severity of the gynecomastia grade this will determine the type of incision, sometimes it can be less, in some cases, it can be more if a second stage reduction is needed.