BBC TV Program on Gynecomastia
Mr. Koo: People talk about gynecomastia as being “man boobs,” but in fact gynecomastia means “woman boobs on a man.” “Gyneco,” as in gynecology, and “mastia” from “breast.” And, in technical terms, gynecomastia occurs – was said to occur – when there is a breast disc. A lump under the nipple that you can feel. More often it’s not just the swelling of the breast tissue, and quite often there’s a lot of surrounding fat. Gynecomastia can have such an effect on a man’s life that, when he’s got to the stage where he’s struggling to live with the way things are, he really needs to understand that there is a surgical solution. There is an operation which can help him.
Narrator: In America, breast reduction surgery is now the fourth most popular cosmetic procedure for men.
Dr. Delgado: The pressure on men to look good is huge. You look in the newspaper and magazines: clothes, hair, gel, smells. You know, exercise, dieting. All these things are about people looking good and feeling good about themselves.
Narrator: In a country where men strive for physical perfection, having breasts can have a devastating effect on a man’s body image. Alex Gonzalez is so inhibited by his breasts that he has never undressed in front of another person – let alone a woman – and at 30 years old, is still a virgin.
Alex: It’s funny cuz that movie that came out, “40-Year-Old Virgin,” I said gosh it’s gonna be ten more years and that movie is gonna be just dedicated for me. And it’s sad. I’ve had three or four girlfriends, that I consider my girlfriends, but I’ve never been intimate with them. And before it goes to that step, I end it.
Narrator: No one has ever seen them and it took days for him to psych himself up to show us his chest.
Alex: Even by myself, I could get embarrassed taking off my shirt. When I’m by myself I go to the bathroom and I just look at my face and I look on my chest. I just block it out. My life is not going anywhere unless I correct my condition. That’s how I feel right now emotionally.
Narrator: Alex has made the decision to have surgery and is flying to the west coast to see a specialist in male breast reduction.
Alex: Hopefully, this is gonna be for the good. I’m just being very positive because I think it’s the best thing to do – just be positive about it and it’ll come up okay.
Narrator: He is going alone, having told his friends and family he’s on a university trip. Alex is hoping surgery will give him the confidence to leave his lies and secrets behind. Alex has chosen a specialist in San Francisco. Dr. Delgado treated nearly a hundred men last year.
Dr. Delgado: It’s going up every year, without question. It’s going up every year. Our culture is very hard on men for having a large chest. It’s very accepting for a man to have a large gut, I mean no one even thinks about it. But as soon as it comes through their chest, it changes completely.
Narrator: First, Dr. Delgado examines Alex’s chest.
Dr. Delgado: Okay, I want you to just relax. Now, the first thing is – great, you have nice pecs. You know, which is really good. You have fairly good quality skin. Why don’t you just give me a nice flex with your pec. Okay, and so all this is the tissue that we’re talking about. Okay, cuz…
Narrator: It’s the first time anyone has ever touched Alex’s breasts. Dr. Delgado uses pictures so he can compare Alex to other cases and show him the options available.
Dr. Delgado: You can see the protrusion of the nipple and what’s poking that nipple out is that hard gland there. And so afterwards, we’ve got a nice –
Alex: So the gland is right underneath the nipple –
Dr. Delgado: Yeah, that’s the center of the gland. This is what I call the “Smooth P” look from when you do liposuction only. He’s had it done twice. It’s so that gland is just, kind of like, hanging down. So after the gland’s taken out, then we get a much more contour and contraction there. A patient like this, you know, I know he’s going to have loose areola. Look how stretched that is. And this, he has a case where I’d do a secondary procedure on him, but I’d tell him that upfront because I know there’s no way that this is going to shrink back.
Narrator: Approximately ten percent of men who have gynecomastia surgery go back for another procedure to remove loose skin or breast tissue that wasn’t taken the first time round. It’s the morning of Alex’s operation.
Dr. Delgado: Hey Alex, how you doing?
Alex: Good, doctor. All set to go.
Dr. Delgado: Good. Bit of a bee sting.
Alex: I’m actually looking forward to this change. It needs to happen now.
Narrator: Dr. Delgado treats patients from all over the states and has men travel from other countries to see him. He has a particular technique for achieving a smooth, overall contour. Rather than just focusing on the front of Alex’s chest, he performs liposuction from the sides and back as well.
Dr. Delgado: When I do liposuction of the armpit area, I turn the patient on their side and I stretch the arm out to really expose it well. And then I make one or two holes to extract the fat in a very aggressive way. The more fat we take underneath the skin, the better contraction we’ll get. So the elastic fibers can do their work. I place the patient elevated at about 70 or 80 degrees. That allows me to see how gravity affects their chest. I’m comparing side by side and I’m trying to do, to the best of my ability, to match them. It’s like an artist painting, you know. He’ll sit there for hours and just paint landscape. Well I’m kind of doing that in my own world.
Narrator: After four and a half hours of surgery, nearly five and a half pints of fat and breast tissue have been removed from Alex’s chest.
Dr. Delgado: You’re doing great. Put your arms right down here by your side. Take a nice deep breath.
Narrator: Alex will have to wait at least a month to have his dressings and stitches removed. But the next morning, he can’t resist taking a peek at his chest.
Alex: Looks good from up here. Quite different. I mean, it’s still swollen. I think it’s gonna take more months for it to go down, but it’s gonna be great, I think.
Dr. Delgado: Hey Alex, how you doing?
Narrator: Dr. Delgado comes to check there’s no bleeding.
Dr. Delgado: You look perky. Good. Let’s see you. From this side, everything looks nice.
Narrator: There is no doubt that Alex’s operation has been a success. And, with that knowledge, he can start to look to the future.
Alex: It was quite hard but I’m glad I did it, cuz I feel – I do feel better. And I do feel better about myself. I’m looking forward to a new life more than anything.
Dr. Delgado: As I told Alex, your chest will look good in a few months. Your mind and the way you look at yourself has to catch up to it. You still have to get over the scars that have been implanted in your mind about your self-image and he will get there, but it just takes a little bit of time.
A month after filming Alex told his family about his surgery.
Dr. Delgado: In my experience, men after having this surgery – as a general statement – are very happy. Extremely happy. Life-changing happy.
He is now dating.