HISTORY: This is a 24-year-old resident of San Francisco, California who presents to the San Francisco, California office for evaluation of his gynecomastia. His male breast enlargement has been present for ten years. He does have pain and tenderness in the chest area. His discomfort is more on his left side than his right side. He is not comfortable taking off his shirt since he is very self-conscious. His goal is to remove excess tissue and to have a more muscular appearance. He underwent gland excision and chest liposuction. He had 200 cc of fat aspirated from each side. His surgery was performed at Marin Cosmetic Surgery Center in Marin County, California. His photographs were taken 2 ½ months after surgery.