Santa Rosa, California This is a 22 year old male who presents to the Novato office for treatment of adolescent gynecomastia. His primary complaint is puffy nipples. He has had previous male breast reduction surgery approximately three years ago and is not happy with the outcome. He underwent revision gynecomastia surgery with gland excision and suction assisted lipectomy at the Marin Cosmetic Surgery Center in Marin County, California. He had 11 grams removed from his right side and 8 grams removed from his left chest. In addition we placed Marcaine and a small amount of Kenalog in the pocket for irrigation due to previous scarring. He developed a small area on his right side of a small amount of fluid collection which was aspirated twice and then resolved spontaneously. His photographs are taken six weeks after surgery.