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Sacramento, California: This is a 15-year-old boy with severe gynecomastia who presents to the San Francisco office for treatment of his gynecomastia. He has had his gynecomastia from a very young age and has caused significant issues at school as well as unable to expose his chest due to extreme embarrassment. His goal is to be able to take off his shirt in public and have a normal life. Due to the extent of his gynecomastia it is likely that he would require a two stage procedure the first being gland excision and suction assisted lipectomy and his second being skin excision with a periareolar incision. His gynecomastia treatment was performed at Marin Cosmetic Surgery Center in Marin County, Novato, California. He underwent gland excision and liposuction of his chest in which he had 230 grams removed from his right chest and 219 grams removed from his left chest. He underwent a periareolar skin reduction approximately 10 months after the initial procedure. Photographs are seen 13 months after the initial surgery. Dr. Miguel A. Delgado is a renowned gynecomastia specialist who performs gynecomastia surgery for patients all over the United States and throughout the world. He has produced many documentaries regarding gynecomastia that have become verypopular on YouTube -http://www.youtube.com/user/migueldelgadomd1/videos . He sees patients throughout the California area including Los Angeles, San Diego, Sacramento, San Francisco, and the San Jose area. He sees many patients throughout the west coast in the mid west region. A large part of his practice is revision gynecomastia surgery.