This is a 20 year old male who was bothered by the fullness in his chest since 13 which developed on both sides at the time of puberty (most common cause of gynecomastia which affects about 10 percent of all males). He did not like the “puffy” nipple and affected his self-esteem and wearing fitted shirts or even taking shirt off to go to the beach or pool. Minimal incision approach to excision of gynecomastia with chest-wall contouring of the pectoralis edge is shown with early 2 month results. Shape improvement is evident and even some areolar size reduction is apparent which he is ecstatic with.