This is a 32-year-old resident of San José, California who presented to the San Francisco office location in Union Square for evaluation for gynecomastia. He is 5 feet 11 inches and weighs 240 pounds. He has had undescended testicles and, therefore, his testosterone levels were low, causing him to develop gynecomastia. Due to the medical condition causing his gynecomastia, his surgical procedure was able to be covered under his health insurance. He underwent glandular excision with a superior lift and liposuction of the axillae. The right axilla had 800 cc of fat extracted. The left side had 700 cc extracted. The pathology showed an excision of 192 grams of tissue removed from his right side and 168 cc removed from his left side. This is a good example of a case that can be covered under insurance, in that his gynecomastia was caused by another medical condition. The surgery was performed without any large amount of skin excision except for an incision above the areolae, raising the areolae upward. He required a peri-areolar lift to further tighten his skin and gain more tightness in his chest due to the redundant skin. However, note the extreme condition of his gynecomastia and the incredible amount of skin contraction that was able to be achieved without excising skin.