Background: Plastic surgery role in correction of post-bariatric gynecomastia is clinically called reduction mammoplasty by reducing breast size, flattening and enhancing the chest contours. Objective: This study aimed to assess the aesthetic outcome of management of post-bariatric gynecomastia in Zagazig University Hospitals. Patients and methods: Randomized-controlled clinical trial study was carried out in Plastic & Reconstructive Surgery Department, Zagazig University Hospitals during the period from February 2018 to February 2020. It included 30 patients with post-bariatric gynecomastia. Patients included in the study was divided into two groups: Group A that included 15 patients who underwent postero-inferior pedicle surgical technique, and group B, which included 15 patients who underwent circum-areolar reduction surgical technique (Doughnut Technique). Results: In group (A), there was no residual skin redundancy in all cases of that group. Nipple necrosis was found in two (2) cases, and the rest was intact. Four (4) cases were presented by a defective scar and eleven (11) cases had no defective scar. Hematoma was found in only one (1) case. In group (B) that was corrected with circum-areolar reduction surgical technique, there were five (5) cases with nipple in-sensitivity, and ten (10) cases with intact nipple sensation. Four (4) cases with no nipple projection, and eleven (11) cases with normal nipple projection. Residual skin redundancy was complicated in eleven (11) cases, and four (4) cases with no skin redundancy.  Conclusion: The postero-inferior pedicle technique gave better results than the circum-areolar reduction surgical technique especially in grade IV post-bariatric gynecomastia.