A 14 boy with gynecomastia (feminine breast development) of idiopathic (unknown) cause is shown before and 4 months after surgery with a combination of liposuction and direct excision. The small scars in the upper chest and at the lower edge of the areola are barely visible at 4 months, but will continue to diminish over the next 18 months. He already feels comfortable going without his shirt in gym class.