A male student in his late teens who developed female appearing breast tissue in the 3rd-4th grade. He has no history of marijuana or anabolic steroid use, so his case is typically “idiopathic” or of unknown cause. He has tried lifting weights to build up his chest muscles but without improvement. He has not had any significant weight change. He is bothered in fitted shirts and of course with his shirt off. “Shirts vs Skins” in gym class must have been a torment. He is shown just before and again, 5 months after bilateral gynecomastia correction with External Ultrasound assisted/power assisted liposuction combined with direct excision of breast tissue through an incision along the lower areola. 355 cc of lipoaspirate were take from his right side along with the direct excision of 40 gms of breast tissue, and 375 cc of lipoaspirate take from his left side together with 37 gms of breast tissue. A close look will show that the scars are still slightly read but they are not noticeable from a conversational distance and will continue to fade over the next 18 months. He is thrilled to have a normal chest.