'Man-boobs' curse sends US teens running for the knife

'Man-boobs' curse sends US teens running for the knife

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Alex Kuczynski, New YorkJune 16, 2007
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ON A recent afternoon, Dr Michelle Copeland, a plastic surgeon whose offices face the Metropolitan Museum of Art, clicked her computer mouse as images of young male torsos flickered across the screen.

Unlike the ancient Greek statues of Herakles or the bronze discus throwers in the newly renovated galleries across the street, the young men in Copeland's digital images were a bit different: rather than bearing the broad, flat chests of Greek athletes, their pectoral areas assumed a fuller, more feminine shape.

The patients were found to have enlarged male breasts, a condition known as gynaecomastia. While it is not a new disorder, more men are seeking treatment for it, and statistics from the American Society of Plastic Surgeons show that the majority are adolescent boys.

In 2006, according to the group, nearly 14,000 boys age 13 to 19 underwent surgery to reduce their breast size. That represents 70 per cent of all the male patients who had such surgery last year, and an increase of 21 per cent over the previous year for that age group.

In a culture that increasingly encourages young boys to be body-conscious, demand for chiselled torsos and sculpted pectorals is rising, so much so that the number of boys aged 13 to 19 who had breast-reduction surgery last year is equal to the total number of all men who had the procedure just two years earlier, in 2004.

The foremost reason is the rise in obesity, according to several plastic surgeons who were interviewed. At the same time, there is a new willingness among pediatricians and plastic surgeons to surgically treat enlarged male breasts.

Often, enlarged breasts are simply part of adolescence, most commonly caused by the hormonal fluctuation of puberty, according to the National Institutes of Health. But in a society that values chiselled abs and Rafael Nadal biceps, adolescent boys are willing to resort to surgery to fix problems their bodies might resolve later on their own.

David Zinczenko, editor-in-chief of Men's Health, says that many of his magazine's readers are concerned about having enlarged breasts."The sad thing is that it's a fairly common problem among young teenagers, which is usually resolved by the latter stages of the testosterone rush that finishes off adolescence," he says. "But add some fat in there, and a cut-happy approach to body oddities, and you've got teens under the cosmetic knife."

The shame can be intense. One of Dr Copeland's patients, now 17, had breast reduction surgery at 15. His problem was not one of obesity but of glandular overgrowth. "I took my shirt off once, and a couple of kids laughed at me, and I never took my shirt off again," he said. His pediatrician was opposed to the surgery, but the young man, a student at a Manhattan private school, had the support of his parents."It sounds cliched and kind of lame, but it just comes down to a point of embarrassment," he said. "You don't think you look like you should. If I was fat, I could have lost weight. If was weak, I could have exercised. But this was simply genetic, and there was nothing I could do about it."

The condition is a punchline in sitcoms and movies. In a now-famous episode of Seinfeld, the character Kramer invented "the Bro", a bra for men with breast development.A British website welcomes readers with the slogan: "Welcome to Man Boobs. The site that says: 'We're fat and we're proud' and then quickly puts its T-shirt back on."And several websites, such as gc2compression.com and makemeheal.com, sell compression garments that purport to reduce the visibility of enlarged male breasts.

While gynaecomastia in young men is most often associated with hormonal fluctuations or obesity, many surgeons are also beginning to link it with increased abuse of steroids. "They have hopped up their testosterone levels, and so when they get off the stuff, there is a change in the hormonal milieu," says Dr Roxanne Guy, a Florida plastic surgeon."It can reset itself, but many times if they have abused steroids, you have to sendthem to an endocrinologist to address the problem." If that doesn't work, they come back to her for surgery.

The reduction procedure depends on the size and composition of the breast. Some surgeons simply use liposuction to remove fatty deposits. If the breasts are enlarged with not only fat but also extra glandular tissue, the surgeon must remove both.

The procedure does not require general anaesthesia, but it typically requires several days of bed rest. The price range is $US4000 to $US10,000 ($A4700-$11,900), depending on the complexity of the procedure.

Nathan Johnson, a 31-year-old actor in Manhattan, had the surgery while in his early 20s. "I was definitely a morbidly obese child," Johnson says. In his late teens, he lost weight but was left with a sagging chest."I had these big pockets, little pointy sagginess that looked like pointy breasts. No matter how much I dieted or worked out, I couldn't get rid of them." Guy performed surgery, but Johnson remained nervous for a year about removing his shirt. "People love my body now," he says.