A 17 yo who developed bilateral gynecomastia at the age of 12, and is bothered by a female appearance of his chest. He wears extra shirts to camouflage his appearance and has been taping his breasts down with adhesive tape. He does not have a history of marijuana or anabolic steroid usage. His cause is most likely idiopathic- which is the most common presentation at puberty and is a word that means the cause is unknown.
He is shown before and again, 6 weeks after power assisted/external ultrasound assisted liposuction combined with a direct excision of breast tissue from a periareolar incision.