This video demonstrates that even very large size Man boobs / Gynecomastia can be very safely and completely operated upon totally under local anesthesia by the tumescent technique. There is no need to be fasting for surgery. There is no need for admission in hospital. Surgery is performed like an out-patient procedure. Patients for surgery come after light breakfast at home and may go home immediately after surgery is over. Patients are awake, pain-free and conversant throughout surgery. Tumescent ‘awake’ technique has a very high safety profile.