Male breast hypertrophy or gynecomastia most commonly appears early in puberty and persists into adulthood. This 17 year old developed enlarged breasts as a 13-year-old and was bothered by it. He does underwent VASER and power-assisted liposuction to remove the tissue. VASER or ultrasound energy is very effective at breaking up fibrous tissue and often removes the need for formal bud excision with its incision below the nipple. He is six weeks postop.