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HISTORY: This is a 52-year-old resident of Folsom, California who has had gynecomastia surgery in 2003. His gynecomastia surgery procedure was liposuction only. He presents to the San Francisco office for improvement in his chest shape. He does not take off his shirt in public due to embarrassment and his goal is to acquire a flat contoured chest. He underwent revision gynecomastia surgery with gland excision and suction assisted lipectomy of the chest and the axilla. He underwent 400 cc of fat excised from both the left and the right axilla and liposuction approximately 200 cc from his chest on each side.He had 41 grams excised from his right side and 78 grams from his left side. His surgery was performed at Marin Cosmetic Surgery Center in Marin County, California. His photographs are seen 3 months after surgery.