Gynecomastia awareness and treatment have increased significantly. Treatment of gynecomastia is now one of the most popular procedures requested by men. There are many gynecomastia classification systems that have been described. The usefulness of these classifications in the diagnosis and treatment of modern gynecomastia is unknown and has fostered confusion among surgeons and patients. This article elucidates the topographic pattern consistently seen in gynecomastia patients and relates this to the diagnosis and treatment of gynecomastia. The proposed gynecomastia zone classification is a simple and objective method to clinically describe gynecomastia and direct appropriate treatment.