Richmond, California This is a 30 year old male who presents with adolescent gynecomastia and treatment with male breast reduction surgery. Due to the complexity of his case, it was suggested that he would probably require a secondary procedure which involved a periareolar lift for a more optimal outcome due to the laxity of his chest skin. He underwent gland excision and suction assisted lipectomy at Marin Cosmetic Surgery Center, followed by a Stage II periareolar lift for skin tightening. In the initial surgery he had 42 grams removed from his right side and 37 grams removed from his left side. His photographs are seen approximately 7 months after the initial surgery. His initial surgery was complicated by having a left chest hematoma which was evacuated the following day.