Grade 1 

Grade 1 gynaecomastia is the mildest form of the condition. In Grade 1 a small amount of breast tissue enlargement is concentrated around the areola. The breast tissue is not noticeable.

Grade 2  

Grade 2 is characterized by moderate breast enlargement with a breast bud diameter of up to 2 centimeters. In this breast tissue extends beyond the areola but does not exceed the boundaries of the breast contour.

Grade 3

Grade 3 gynecomastia is a severe form of gynaecomastia and can be identified as significant breast enlargement, excess skin, breast sagging.

The areola and nipple get displaced to a lower position.

Grade 4

Grade 4 gynecomastia is the most severe form, and results  in skin sagging. The breast tissue is enlarged and hangs below the breast crease.

No, Gynecomastia starts developing during puberty or due to ageing because of hormonal imbalance. The abnormal swelling of male breast tissue leads to body-image issues.
Gynecomastia surgery is the only possible solution to this condition.

Usually it is recommended to wait until age 17 or 18, when hormonal fluctuations stabilize. However, in case of severe psychological distress surgery can also be considered early.