Objective To explore the effect of liposuction combined with minimally invasive atherectomy in patients with gynecomastia. Methods A total of 62 patients with gynecomastia admitted to Shenzhen Jumei Boyue Medical Beauty Clinic from July 2022 to April 2024 were selected as the research subjects, and they were divided into control group and experimental group by the random number table method, with 31 patients in each group. The control group was treated with circular areola micro-incision resection, and the experimental group was treated with liposuction combined with minimally invasive atherectomy. The clinical efficacy, clinical related indicators, scar degree, satisfaction and complications were compared between the two groups. Results The total effective rate of treatment in the experimental group was 96.77%, which was higher than 77.42% in the control group (P <0.05). The operation time, incision length, incision healing time, hospitalization time and VAS score in the experimental group were better than those in the control group (P <0.05). The scores of scar color, vascular distribution, thickness and softness in the experimental group were lower than those in the control group (P <0.05). The scores of bilateral symmetry, chest flatness and skin sensation satisfaction around the nipple in the experimental group were higher than those in the control group (P <0.05). The incidence of complications in the experimental group was 6.45%, which was lower than 29.03% in the control group (P <0.05). Conclusion The application of liposuction combined with minimally invasive atherectomy in patients with gynecomastia is effective, which can increase the total effective rate of treatment, improve the clinical related indicators, reduce the scar degree. The risk of postoperative complications is low, and the application safety is high.