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This 33-year-old man is 5’10” and 250lbs. He developed adolescent gynecomastia and never was able to expose his chest due to severe discomfort. He underwent glandular excision as well as ultrasonic liposuction of the abdomen, flanks and axillae, from which I extracted a total of approximately 8000cc of fat. His goal was “to feel comfortable in a T-shirt.”