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Gynecomastia has been classified by various systems mainly based on surgical management, the severity of gynecomastia, physical appearance, and etiology.
Grade 1: Minimal excess skin and fat with minimal alteration of nipple-areola complex (NAC) and inframammary fold (IMF)
1a: No lateral skin roll
1b: Lateral skin roll
Grade 2: Nipple-areola complex (NAC) and inframammary fold (IMF) below the ideal IMF with lateral chest roll and minimal upper abdominal laxity
Grade 3: Nipple-areola complex (NAC) and inframammary fold (IMF) below the ideal IMF with lateral chest roll and significant upper abdominal laxity
Barros's
Physical
Grade I: Increased diameter and slight protrusion limited to the areola region
Grade II: Moderate hypertrophy of the breast with the nipple-areola complex (NAC) above the inframammary fold (IMF)
Grade III: Major hypertrophy of the breast with glandularptosis and the NAC situated at the same height as or as much as 1 cm below the inframammary fold (IM)
Grade IV: Major breasthypertrophy with skin redundancy, severe ptosis, and the NAC positioned ≥1 cm below the inframammary fold (IMF)
Çi̇l's
Imaging (computed tomography)
Gynecomastic adipose tissue/total gynecomastic tissue is <0.3
Gynecomastic adipose tissue/total gynecomastic tissue is 0.3–0.5
Gynecomastic adipose tissue/total gynecomastic tissue is >0.6
Cordova's
Physical
Grade I: Increase in diameter and protrusion limited to the areolar region
Grade II: Hypertrophy of all the structural components of the breast and the nipple-areola complex (NAC) is above the inframammary fold (IMF)
Grade III: Hypertrophy of all the structural components with nipple-areola complex (NAC) at the same height as or approximately 1 cm below the inframammary fold (IMF). In this group we can also include male tuberous breast
Grade IV: Hypertrophy of all the structural components with nipple-areola complex (NAC) >1 cm below theinframammary fold (IMF)
↑Wollina, U; Goldman, A (June 2011). "Minimally invasive esthetic procedures of the male breast". Journal of cosmetic dermatology. 10 (2): 150–155. doi:10.1111/j.1473-2165.2011.00548.x. PMID21649820.
↑Simon BE, Hoffman S, Kahn S (1973). "Classification and surgical correction of gynecomastia". Plast. Reconstr. Surg. 51 (1): 48–52. PMID4687568.