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This is a 36-year-old male from Vacaville, California, who developed adolescent gynecomastia and was also possibly enhanced by steroid usage for body building. He had gynecomastia surgery in 2001 and 2009. He presents to my office in San Francisco, California, for evaluation and treatment for revision gynecomastia surgery. He underwent gland excision and liposuction at Marin Cosmetic Surgery Center in which he had 8 grams of tissue removed from his right and 5 grams of tissue removed from his left side. His postoperative photographs are seen at three months after surgery.