Gynecomastia may be unilateral (L>R) or bilateral. Hormone-induced gynecomastia is usually bilateral, where as drug-induced (nonhormonal) is usually unilateral. This photograph shows unilateral gynecomastia in a 36 y/o male with history of chronic alcohol abuse. His left breast showed progressive tender enlargement over 1 year. Case courtesy of: Dr. Sanjay D. Deshmukh, Professor of Pathology, Vithalrao Vikhe Patil Foundation's Medical College & Hospitals, Ahmednagar, India.