This is a 19 year old male that had been was bothered by fullness in the chest area since very early puberty. He particularly felt like he had “puffy nipples”. This was debilitating for him and affected his self-confidence. He was embarrassed to take his shirt off and also did not like his appearance in certain shirts. He underwent a “pull through” minimal excision approach to gynecomastia with chest wall contouring. 6 month after results are shown.