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San Francisco, California: This is an 18-year-old man who presents to the San Francisco, California office for evaluation of his adolescent gynecomastia. He has had male breast enlargement since the 5th or 6th grade and it has been persistent over time. He does not take off his shirt and wants to become more active in his life. His goal is to slim down his chest and to wear a t-shirt and go without a t-shirt very comfortably. He underwent gland excision and suction assisted lipectomy in Marin County California at Marin Cosmetic Surgery Center in Novato, California. He had 67 grams of tissue removed from his right chest and 27 grams removed from his left. He has been seen approximately three months after surgery. The surgery was performed by Dr. Miguel A. Delgado who is a gynecomastia expert and performs gynecomastia surgery for patients all over the United States of America and the world. His practice consists of many gynecomastia revision surgeries of 35 to 40% of his practice which is a testament to his skill and experience. He has produced many documentaries regarding gynecomastia that have become very popular on YouTube -http://www.youtube.com/user/migueldelgadomd1/videos . Dr. Delgado sees many patients from the west coast including Los Angeles, San Diego, Sacramento, and San Jose, in the California area. He sees many patients from Washington and Oregon State as well as the entire west coast.