The last 30 years has seen a shift in surgical treatment of breast diseases to less invasive, more conservative treatment options. The mammotome equipment was originally introduced as a diagnostic tool, but advances in technology have extended its role to therapeutic procedures. The mammotome device (8-gauge) is inserted through a cosmetically placed 4-mm scar and breast tissue is resected sequentially using a suction facility without the need to remove the biopsy device. This is done under ultrasound guidance. Operative morbidity and postoperative score for cosmesis and patient satisfaction were recorded prospectively. Patients were reviewed in the clinic after 6 to 8 weeks. Five patients (4 unilateral, 1 bilateral) with idiopathic gynecomastia were treated. Mean age was 41.8 years (range, 16-88 years) with a median procedural time of 32 minutes. No postoperative morbidity was noted and mean cosmetic score was 9/10. The mammotome is an emerging minimal invasive tool that is safe and ensures excellent cosmesis and very high patient satisfaction rates.