This 38-year-old man is 6’4″ and 270lbs. He suffers from adolescent gynecomastia in addition to von Willebrand’s disease, a bleeding disorder. With the appropriate drugs to enhance his clotting ability, he was able to proceed with surgery. He underwent glandular excision and suction-assisted lipectomy of the chest, from which I extracted 400cc of fat bilaterally.