This 26-year-old man was 300 pounds overweight as a child, and as a result developed adolescent gynecomastia. He underwent gynecomastia surgery initially in 1994 with another surgeon, consisting solely of liposuction of the chest. Dissatisfied with his initial results, he came to me for a secondary procedure. I performed a revision surgery on him, consisting of glandular excision and suction-assisted lipectomy, from which I removed a total of 850cc of fat bilaterally.