Total number of patients with high-grade (Simon's grade IIb and III) gynaecomastia was 12. Mean age of presentation was 25.8 year (range 14-42 years). All of these 12 patients presented before us because of emotional discomfort; among them, five (41.6%) patients also had difficulties in entering into social relationships like marriage. Ten (83.3%) patients had bilateral and two (16.7%) patients had unilateral high-grade (Simon's grade IIb and III) gynaecomastia. Regarding Nipple Areolar Complex (NAC), four patients had bilateral enlarged with mild displaced NAC; five patients had bilateral enlarged and displaced NAC; two patients had unilateral enlarged and displaced NAC; one patient had a very unique presentation, unilateral (right) sided enlarged areola with bilateral displaced NAC.