HISTORY: This is a 25-year-old resident of Lompoc, California who presents to the San Francisco, California office for evaluation for his gynecomastia. He has had chest enlargement since approximately 25 years old. He had a weight gain to 250 pounds and dropped down to 200 pounds. He has had the breast enlargement for most of his life as far as he can remember. He does not take off his shirt in public due to feeling uncomfortable that women are looking at him. His goal is to be able to feel better about my body. He is 62 and weighs 200 pounds. He underwent gland excision and suction assisted lipectomy of his chest and liposuction of the axilla or arm pit area. His surgery was performed at Marin Cosmetic Surgery Center in Marin County, California. We extracted 400 cc of fat from each side. Due to the laxity of his skin we made a superior incision for a breast lift. The amount of tissue excised was 67 grams from his right and 41 from his left side. His photographs are seen 3 ½ months after surgery.