23 year old patient that works out frequently. Admits to taking supplements and prohormones to enhance his muscular frame, then developed fullness and tenderness/shape change to the chest/nipple area, especially on the left side. He underwent pull-thru excision of gynecomastia through a minimal incision with “hockey-stick” lower pole etching and contouring of chest wall. 4 month after results are shown with shape improvement to chest, nipple complex with good flattening of the “puffy nipple”.