38 year old male presented for gynecomastia treatment. My personal approach is the VASER sculpting technique via "stealth" incision both for the liposuction and tissue removal through the same 1cm opening in the areola. It is not only the removal of the excess fat and breast tissue, but transforming the chest into an angular, masculine anatomy without scars. I define the lateral pectoralis major muscle lateral edge, the anterior border of the latissimus dorsi muscle, remove the fat over the rib cage between these muscles, define the midline of the chest between the two pectoral muscles, remove all the tissues below the muscle to promote skin tightening over the ribcage below the muscle. This is gynecomastia surgery taken to an advanced level.