About five years ago, my grandma nearly drove my baby brother to tears over Thanksgiving dinner.
Mikes was standing at the counter, dreamily eating crackers and watching our mother wrestle with the turkey, when my grandma reached out and tweaked one of his nipples through his shirt.
“He’s got breast buds!” she laughed. “We’re gonna have to get you a bra soon!”
My grandma has never been what one might call “tactful.” I still remember the time she hugged me when I got home from college and asked, perplexed, “Where’s your back fat?” But it was still awful to watch my brother’s sweet, good-natured face crumple, his neck bloom red with anger and embarrassment. Worse, I don’t remember any of us coming to his defense.
A year later, he became part of a growing number of men who undergo reconstructive surgery to fix what my grandma called his “man boobs” and what his doctors called “gynecomastia.”
Surgery to reduce gynecomastia, or the abnormal enlargement of breast tissue in cis males, has become much more common in the last few years. In 2011, it was one of the most popular cosmetic surgical procedures for Americans, and the number of Brits who underwent the procedure doubled.
What fascinates me about gynecomastia is the illusion that it’s a choice -- unlike having a big nose or ears that stick out, “man boobs” are often used as a synecdoche for what I often think of as the “Peter Griffin:” the kind of lazy, basement-dwelling schmuck who so often plays the lead in Judd Apatow movies. It’s more than a little fatphobia, of course, but it’s also the presumed punishment of emasculation: like no man would want to be saddled with the very body parts that they idolize on women.
But, hey, what do I know. My baby brother was nice enough to drag himself away from his busy freshman-in-undergrad life to talk to me about his surgery, the reasons for it, and how it affected his self-esteem. Bonus: lots of the two of us stuttering over the word nipples! Because he is my brother, and that will never not be weird.
Kate: So, I know that you got gynecomastia surgery when you were -- what, fourteen?
Mikes: Fifteen and a half.
K: Fifteen and a half. How old were you when you started developing -- uh, breasts? How did that manifest?
M: I was maybe like twelve? And they weren’t so much breasts, so much as my nipples got big and puffy. They didn’t, like, widen or anything, but they got puffy, and a hard spot behind them started to develop. It was tender, and it hurt to the touch.
K: Really. Did they always hurt to the touch?
M: Not at first, but as the years went on, it got more and more painful.
K: Did they hurt when you, like, ran, and stuff? [Makes an abortive movement toward her own breasts, as if to symbolize jiggling while running]
M: I didn’t really notice them bouncing, or anything, but they hurt when I, like, bumped into things with them.
K: So, basically like breast buds, then. How big did they eventually get? How big were they when you decided to get the surgery?
M: They were probably -- I don’t know, maybe about this big?
M: I mean, they were pretty puffy.
K: What made you decide to go to a doctor about this? What compelled you to be like, "This isn’t normal, maybe I should seek medical attention?"
M: Well, I mean, I would look at all my friends’ nipples when they had their shirts off -– okay, that sounds weird. [Brief interlude of giggling] But I could see them, and they just definitely did not look the same. The looks were definitely part of it, especially back then, when I was younger. But the pain and the tenderness were big aspects. too.
K: So when did you actually decide to go to the doctor?
M: I was maybe about fifteen? And then I got the surgery six months later. Beginning of my sophomore year in high school.
K: Gotcha. I wanted to ask a little bit about the whole “man boobs” thing. A lot of media outlets are taking the angle of “Man boob surgery on the rise.” How do you feel about people calling gynecomastia “man boobs” when it’s actually kind of a medical issue?
M: It doesn’t really bother me too much to hear that now. Maybe back in middle school, because it was, you know. A tender time. But it definitely could be offensive to some people who are more self-conscious about it and view it as a big problem. To me, "man boobs" means a man's chest when he's overweight.
K: Did your nipples start developing when you were kind of on the heavier side?
M: I mean, I wasn’t fat, but I was definitely thicker. When I went to the doctor the first time, they said it could be caused by many things. Being overweight was one of them. So I started doing crew -- rowing -- and it cut down a lot, but while I definitely lost weight and there was some reduction of the chest area, it didn’t really help with the nipple at all.
K: Do you know what caused it initially? Was it hormonal or genetic?
M: I have no idea. They said my testosterone levels were fine, there was nothing odd -– I guess it just develops in teenagers sometimes.
K: Were there any sort of medical dangers associated with gynecomastia? Or was it sort of uncomfortable? Could it have caused any complications further down the line?
M: You know, I’m not sure. But it really wasn’t the medical issue. You know, I didn’t want to take my shirt off ever -- even with it on, you could kind of see them protruding, and it was just -- it wasn’t so much the medical danger. There could be, but I’m not sure.
K: So, would you consider this more of a cosmetic surgery?
M: It definitely was cosmetic surgery for me. It was actually done by a plastic surgeon, because Dad thought it would be better for someone with experience to do it as opposed to a different kind of doctor.
K: How much impact did Dad have on your decision to do this?
M: He didn’t have much of an impact; he just wanted to do what would make me happy.
K: This whole self-consciousness issue –- did your friends make fun of you?
M: My friends made fun of me, but that’s not where it came from. It was just me; I was looking at myself, and I just thought that, y’know, I don’t like this. It bugged me. My friends and I always make fun of each other, so that wasn’t so much of an issue.
K: Yeah, I remember Grandma talking about your breast buds and stuff.
M: Remember when Dad did that, too?
K: No, I don’t remember that.
M: Yeah, we were in New York or something. You all started making fun of me.
K: Oh, noooo! I don’t remember that! I mean, it -- it clearly hadn’t developed into –- uh.
M: Yeah, it was when we were in New York the first time.
K: Well, I’m sorry retrospectively for making fun of you when you were at such a tender age.
M: Such a tender age.
K: So, are you happy with your decision to get the surgery now? Do you wish you would’ve waited a while to see what would happen? I know you still have some residual puffiness.
M: You know, I think it was good and bad. Now that I am confident in myself, and the way I am –- don’t laugh at me -- I’m okay with myself, and I definitely wish that I hadn’t gotten it. Because they would have gone away naturally, probably, and there wouldn’t have been scars and stuff. But I will say that for that year right after the surgery, it definitely made me feel a bit better. So that was worth it.
K: Do you think that if you hadn’t gotten the surgery, would you have been able to accept the way that your breast tissue developed? Or would have that still have been an issue even with your self-acceptance?
M: That’s really hard to say. Because like I said, the year or so after my surgery, it really helped me to develop and feel confident in myself. But if everything had turned out the same, I think I would be able to accept [gynecomastia] now.
And now they’re kind of -- for a while, they looked normal, but now -- this is going to sound weird, but when my nipples are hard, they look normal. But when they soften, they’ve started to look puffy again. So the surgery was semi-successful, but not completely.
K: Do you think you’re going to do it again?
K: What if they develop into larger, um.
M: I couldn’t really say at this point, but I would have to decide then, really.
K: Okay. Well. Show us your boobs!
Do you know anyone who’s gotten gynecomastia surgery? Do they, like Mikes, feel that they probably could have survived without it? How unfair is it that my 18-year-old brother has apparently come to self-actualization at a much younger age than I ever did? So unfair.
Kate is tweeting (not about nips) at @katchatters.