This is a 19-year-old resident of St. Louis, Missouri who presented to the San Francisco office at Union Square for evaluation for gynecomastia. He is 6 feet tall and weighs 185 pounds. His complaint is the puffy nipples, which causes him severe embarrassment. He underwent gland excision and suction-assisted lipectomy at Marin Cosmetic Surgery Center in Marin County, California. He underwent excision of 5 centimeters of tissue from his right side and 5 centimeters from his left. In addition, he had 125 cc of fat extracted from his right side and 150 from his left. The photographs are taken eight days after surgery since he is from St. Louis.