Video Transcript

Very few of these men understand what this is, or how common it is.

Almost none of them will ever talk about it to anyone else.

This is the story of three men who wanted to change their condition and their lives.

Kevin: My name’s Kevin. I’m 33 years old, born and raised in San Francisco, California. I decided to come see Dr. Delgado based on a problem that I feel like I had to hold in for maybe a year which is gynecomastia.

David: My name is David Moore and I’m seeing the doctor today to talk about possibly having a treatment regarding my gynecomastia, my condition that affects my chest.

Jerome: At the age of maybe eight or nine, I do remember I was flat-chested, and then something happened. Then my chest area perked up.

Meryl: Gynecomastia is a condition where men or boys develop female-like breasts. It can be from a slight puffiness underneath the nipple to the extreme 48 Triple D and larger breasts. There are certainly many men who wear bras on a 24/7 basis as a consequence.

Gynecomastia is relatively common in adolescent boys, and 90% of the time symptoms disappear in a matter of months, or, as adolescence wanes, a few years later.

But the remaining 10% are burdened with a social handicap that causes a deep and complex shame, and puts one’s relationship with one’s body at risk.

gynecomastia.psstage.com

Meryl: Depending upon the degree of impact, how it’s handled by family, by teachers, by coaches, by peers, it’ll have a great deal of impact upon how this boy learns to deal with it or the interventions that subsequently come with hiding it with clothing all the way through surgery.

Dr. Delgado: I would say my interest in gynecomastia probably started seven or eight years ago, which it was really before it became a real common thing, or as popular as it is now. It’s  cosmetic surger, but it affects these people’s lives almost like a reconstructive procedure can change a person’s life.

Interviews

Kevin: At first it was just chubbiness, or in a normal course of being a little overweight. And something that should, you know and, it should go away.

David: It started when I was about twelve years old or so. Started with just one of my nipples being really hard and sore. You know, just, that’s when it started. And I didn’t know what the hell was wrong, I was a little kid.

Kevin: You take off your shirt and you have friends kind of pointing and laughing and saying, you know, where’s your bra.

Jerome: It just didn’t look right – and then there were those that validated it. That it didn’t look right so when I went to the Navy, the validation wasn’t there – you look like you have titties.

David: It disgusted me. I think it’s disgusting. And it makes me angry, so. It makes me angry that I look that way.

Jerome: So you learned to live around that situation. You learn to mask it as best you can. So for me, what I needed to do is wear tight shirts and what I needed to do was never go to the beach. What I needed to do was never go swimming.

Kevin: It’s depressing, you know. It’s something that, you know, you wish that people – you wish that really it’s only in your eyes, and you can work on it internally. I’ve never had a long-term girlfriend, and the longest was about eight, nine months.

David: When I was a teenager, I would have done anything I could do to get rid of the weight. My nipples looked – I mean, I remember times I was even getting ice and like trying to, you know, cut myself just to try to see it, but I didn’t know what the hell was going on. I just wanted to be normal.

Meryl: So my hope is to help through education – not only them, but to educate the public at large about what this condition really is and what it is not. So that there can be more compassion and understanding and perhaps even intervention so that more boys don’t have to grow up with this terrible shame and secret.

Dr. Delgado: Gynecomastia is a term that a lot of men don’t know about. They’re more hearing things like, you know, girls tits and *****’s tits, and, you know, all these terms that you hear about or slogans that are very embarrassing, or what guys really know it by. But gynecomastia is the real term, and it’s basically male breast enlargement.

Initial Meeting

Dr. Delgado: Kevin.

Kevin: Doctor.

Dr. Delgado: Good to meet you. And obviously, you’re here, you know, about your chest. Can you just tell me a little bit about that? What bothers you?

Kevin: Sure. I feel I’ve had a problem with the chest area that for many years – from, I would say, adolescence on – it was something that I felt was kind of part of growing pains, or being chubby, or something. That it would go away with exercise, and then after years and years of just basically trying, and um, seeing my body develop, I find out that it seems to be here to stay. Over the years, you know, I’ve had the, you know, “oh, you know, he’s got, you know, man boobs.” A few comments that it was enough for me to know that it’s easily noticeable, and it was something that didn’t – I wanted to avoid hearing.

Dr. Delgado: How about your partners? Is there an issue?

Kevin: I’ve never had long-term girlfriends. Some of it has to do with just me opening up enough and being intimate enough for a long period of time with somebody. I would say some of that has to do with the self-consciousness I have of my body and it’s prohibited me from, you know, really opening up and settling down with somebody. I definitely shop to find clothes that are loose in the chest area, that have areas around it, that they take the eyesight away from it. You know, big collars, you know, big shoulders if it’s suits or jackets.

Dr. Delgado: Jerome.

Jerome: Yes.

Dr. Delgado: I want to show you some pictures about, you know, what you can expect, you know. I’m going to show you good outcomes, I’m going to show you not as good at outcomes. I’m going to show you, you know, problems that happen because the skin doesn’t contract. So here’s a guy, too  – nice contraction of the skin. He’s got larger areola, it shrunk down quite a bit. The incision you can hardly see, so it’s got, you know, a very nice outcome. Younger man, so the contractions are better. Now here’s a patient where the areola is stretched. It stretched out from the tissue behind it so it’s thin.

Jerome: Yes.

Dr. Delgado: So I know that’s not going to contract as well, and I tell guys, because I because I’ve done enough of them – I mean, you’re gonna have a problem with your skin not contracting, right? You always have to look at what you start with and where you are. Liposuction of the axilla from the back –

Jerome: Yes.

Dr. Delgado: And if you don’t do that, you end up getting this fullness out here because when you’re laying flat on the bed, the fatty tissue falls back and you can’t extract it well. All these guys have a certain amount of gland involved, so you have to surgically remove that – in my opinion – to get a good outcome. Here I’m seeing nice contour, nice and flat. You know, you can see how full that is and you can see how flat that is, and how it’s nicely contracted.

Dr. Delgado: You know the point of what we’re doing here is to show men the reality of this and that there are solutions to it, that you know, it can be successful but there can be hurdles along the way.

Dr. Delgado: Here’s a guy – you can see he’s like a C-cup here. You know, I know he’s going to have some skin issues. I can look at him –

Jerome: Wait, what about these ones right here?

Dr. Delgado: He looks good, he’s got a little fold here. Got a little folded tissue here. There’s none here. You know, he’s smaller on this side, less of a – less skin on this side. He has more skin so I’m not getting as much contraction. So I can improve that.

Jerome: If the outcome is anything like I’m seeing here, it’s a win-win.

Dr. Delgado: It’s a win-win.

Jerome: It’s a win-win, anyway.

Dr. Delgado: I just want to show you some pictures, some before and afters. See afterwards we’ve trimmed it down, we’ve contoured it, the incisions, you know, are good. His overall shape has a nice contour to them. Here’s a guy who we saw – this is a year later –

David: Yeah.

Dr. Delgado: He had liposuction and glandular excision and ultrasound of his chest. But you see how now, this pectoralis you can actually see –

David: Oh yeah.

Dr. Delgado: I like showing this because of the power of contraction of the skin. Look how much it contracted around. I mean that’s with an incision this big, you know. And sos you know, of course I tell this guy “well, you know, you could have a contraction problem.” It may not contract as much down as –

David: Did you have to cut his nipples at all?

Dr. Delgado: No, just the incision. Just one little incision because his – I mean yeah look at the size.

David: It’s amazing.

Dr. Delgado: Yeah.

Gynaecomastia is the most common breast problem in men.

Gynaecomastia itself requires no treatment unless it causes discomfort or embarrassment to the patient. The results of hormone therapy are disappointing, and surgery is therefore the mainstay of treatment.

Initial Examination

Dr. Delgado: I’m gonna examine you and take pictures, and then I want to go over your chest and explain what I see and what you can expect. So, uh, what we’re gonna do is get you ready for surgery, and kind of go over some details and then we’ll – then you – will take some pictures and take your blood pressure, okay?

David: Great, sounds good.

Jerome: Yeah I got my buddy he’s a pastor. Daryl Pearson will be taking me home.

Dr. Delgado: The pastor.

Jerome: Yeah.

Dr. Delgado: Friend of yours, huh?

Jerome: Good buddy of mine. We were roommates years ago.

Dr. Delgado: Yeah.

Jerome: We were in our addictions together. The guy who did something full circle, so yeah. We just kind of met back up in life and he’s my support today.

Dr. Delgado: That’s great, man.

Jerome: This is Pastor Daryl Pearson, and so we’ve been buddies for a long time. And so that’s part of my secret world, is that yeah you know he’s just starting to get to know the real me, the guy that’s been in lockdown and then prison – mental prison, so to speak.

Daryl: I’m here just to support him and encourage him and then really just see him grow as he goes through something that he’s been wanting to go through for a long time.

Dr. Deldago: So, you’ve got good quality skin, which is very important for contraction. Give me a flex of your pec – okay. Why don’t you tell me what you don’t like.

Kevin: I definitely feel that there’s – from this part – there’s kind of the same feeling with them. I feel that, uh, this section here probably is the pinnacle of it. I feel it’s just that fatty look, sagging look again. I see coming in from these angles, as well as he kind of the extra fat there.

Dr. Delgado: And so basically it’s this whole area that you don’t like.

David: Yeah.

Dr. Delgado: Okay, why don’t you flex your pec like you were doing. So, it’s this kind of stuff that’s kind of there, right?

Jerome: Now, I can see it right now. So I can’t look down.

Dr. Delgado: Mm-hmm.

Jerome: On the other side. Now, maybe when I was young I could. So the gravity has definitely set in on me. And so what I don’t like is the protrusion and I think the sagging.

Dr. Delgado: And your goals? What would you like to see?

Kevin: My goals are, would be the flatten this as much as possible. I’d like to see these shrink as much as possible. And I’d like to see the thinning out of this extra fat on the sides.

Jerome: I don’t know what it feels like to be flat-chested. I have no idea what that feels like. Now overall, more than – first and foremost – that is what I’m looking at. And then, definition and then definition and being, having a defined chest area.

Dr. Delgado: Now, I think that we’re on the same page. I think we’ve communicated well what your expectations are and what our limitations are, which the fold’s the issue that may be the one, but other than that, you know, I think you’ll do very well.

Dr. Delgado: Overall I think you should get a very good outcome. I think we’ll be able to flatten this, I think we’ll be able to reduce this bulge that you have here, and I think we’ll be able to take some off here. You want to be careful that you don’t create a divot here or something. But just a little bit less fullness here is going to give us more shape in your chest.

Jerome: I’ve seen people that have come out with amazing results from modern medicine and these procedures. And so, I don’t have a whole lot of questions, I’m just, I’m in a place of, you know, I’m just in awe that the opportunity is presented itself in such a way that, you know, I’ve looked at some of the before and after shots and so I’ve just now got this sense of, uh, I’m just overwhelmed.

Dr. Delgado: That’s great. We’ll take good care of you. We’ll take good care of you. Alright, baby. Let’s go, man. Alright?

Jerome: Alright.

Day of Surgery

Kevin Pre-Surgery Instructions

Assistant: Then I’ll put you, sort of like, in a waiting area, and the doctor will come in and, uh, give you a martini – and I mean martini – and then you’ll wobble into the OR –

Kevin: Okay.

Assistant: And once you’re in there, just so that you know, the worst part is going to be is – I’m gonna have to prep you’ve basically from your neck all the way to your feet. And so – you’re gonna be really cold – and so you’re totally naked, you’re gonna be standing like this, and I’m gonna cover your whole body with betadine. And then what’s gonna happen, once that’s all done – you’re going to not touch anything on the bed because it’s sterile, except you’re gonna just go and sit your butt back as far as you can in the center and lay down and keep your arms out and then just lay them down along.

Assistant: Now I will go over this stuff with you again in the recovery room but you won’t remember a word I’ve said because one of the drugs we’ll give you causes amnesia and I can’t tell you how many times people will say to me, “have I had that operation yet?” Yes, you’re in the recovery room. “When am I going into the operating room?” Five minutes later, you know?

David Pre-Surgery

David: I feel pretty confident and relaxed, you know. I guess I’m excited to see what, you know, what my chest is gonna look like, you know, after the surgery and after it heals and stuff. I’ve lived with this condition for so long and just, I’m actually excited to see it change for once. I know what this looks like and I know what this feels like, and I just know it doesn’t feel good and it doesn’t look good to me, so.

Christine: I’m Christine and I’m the surgery nurse. I’m a circulating nurse. I finished circulating nurse for 17 years and four of those have been with Dr. Delgado, and today we’re going to be doing gynecomastia, which is typically considered a male breast reduction. Well I come in the day of surgery and I have not met the patient before that day. I come in, I introduce myself, and I do a pre-op interview (that’s what we call it) and I talk with the patient. I do some post-op teaching with the patient, and then I’ll prep the patient, take them into surgery, and I’m the one that does the actual surgery with the patient. Afterwards, we bring the patient into recovery, and another nurse will take over and she’ll recover the patient, and that’s the extent of my contact with the patient.

Jerome’s Surgery Started

David Pre-Surgery Instructions

Christine: What’s gonna happen now is Dr. Delgado is gonna come in after he finishes with the surgery, but before yours, he’s gonna come in and mark you with some pens – mark on your chest. Did you shave your chest?

David: Yeah.

Christine: Okay, and then Dr. Gaynor is gonna come in, he’s going to start your ID, ask you any last-minute questions and then I’m gonna come back and give you a breathing treatment. And then you’re gonna walk yourself into surgery. Okay?

David: Okay.

Christine: This is gonna be your best friend for a couple weeks. It’s gonna go just like this – it’s gonna be tight at the top. It’s not gonna be velcroed. We’re gonna tie it – it’s gonna be really tight under the armpits and what we’re going to do is we put foam under this and there’s going to be like Vaseline and you’re gonna – it’s gonna be messy, but just leave it alone, don’t do anything with it, don’t take it off or anything until you see Dr. Delgado at your first post-op visit. And he’ll be the one to take it off.

Christine: Alright, I’ll let you guys say your –

Woman: Love you.

David: Love you guys, too. I’ll see you when you get back. See you, dad.

Man: Take care. Hope you have a good surgery.

David: Thank you very much.

Assistant: Are you excited?

David: Yeah.

Nurse: Good, we do so many of these surgeries.

David: Yeah, I know.

Nurse: Did you do research on the internet?

David: Yeah, yeah I did.

Laura: Well my name’s Laura Tamara and I’m an RN that works here in the recovery room, and basically takes care of the patients after they come out of the operating room, make sure they’re stable enough to go home, handles pain control, makes them – make sure they’re comfortable and they understand their post-op instructions.

Laura: Interestingly I whenever I have a male patient in here I always ask them, “how did you find out about Dr. Delgado?” and they always say from the internet. Whereas women it’s not that much, so it’s more of a word-of-mouth type thing. But with the guys, it’s the internet.

Laura: Most of the patients do really well, so I don’t know necessarily get to see them again but I do know that, after they come out of anesthesia, they’re very happy because often this is a life-changing event for them and they’re very excited about it.

Jerome’s Surgery Complete

Dr. Gaynor: Here we go to recovery. Keep your hands in there, right over your toes. Keep your elbows in tight – yep. My pleasure.

Laura: Jerome, I’m Laura. I’ll be taking care of you here in the recovery room, okay? How you feeling?

Jerome: Oh, a little sore.

Laura: A little sore? Well, that’s to be expected.

Dr. Gaynor: Are those tears of joy?

Jerome: Yes.

Dr. Delgado: How you doing Jerome? How’s it going, man? It’s okay, man. Are you in pain?

Jerome: No, no.

Dr. Delgado: Tears of joy and happiness. I’m glad we can all help you out, Jerome. It’s all over, man. And I think things turned out really nicely, too. Yeah, I’m excited for you, thank God. You just sit back and relax. We’ll take good care of you here. Laura’s a real expert.

Laura: You’re doing fine.

Dr. Delgado: Okay? We’re right here with you, Jerome.

Jerome: Thank you.

Dr. Delgado: You’re so appreciative, man. I love that. I wish all of our patients were like Jerome.

Laura: That would be great.

Jerome’s Recovery Continues

Dr. Delgado: Now we’re done with Jerome and he actually he did very, very well. He’s awake from anesthesia, now – awake, talking, and pain-free, he tells us. And everything went well. I was, you know, quite pleased to think, so. Um, rolling to the second case.

Laura: So, sit up and swing your legs over the side of the bed here, just so you’re on the edge. Let’s see how you feel. But don’t get off the bed.

Jerome: Like this?

Laura: How’re you feeling? Careful, it’s kinda low so be aware.

Jerome: Okay.

Laura: How’s the feel?

Jerome: Good. Good.

Laura: Good.

Jerome: Thank you so much.

Dr. Delgado: Look how good he looks. Ready for a hamburger.

Laura: So we’re ready to go, so unless you have any other questions?

Jerome: No, I’m good to go.

Laura: Okay.

Jerome: Well, thank you, guys.

Daryl: How you feeling man?

Laura: Let’s get you, uh –

Jerome: Feeling pretty good. Got a little pain up top, but nothing – nothing like it was when I first came out.

Daryl: Okay, well [unintelligible]

Jerome: They gave me something for it.

Daryl: How long you been out?

Laura: He came out about 1:40.

Jerome: Well, I’m off to the races. I’m off and enjoying life. Can’t say it’ll be the life, finally, but it’ll be different than what it’s been. Thank you so much.

Assistant: Good luck.

Dr. Delgado: Cases are over, we had a long but very successful day. I think everyone will turn out well. I was very pleased with how things went. Jerome’s gonna be the most difficult due to the extent of his black skin and how large he was. The other two or much younger and should do quite well.

Dr. Gaynor: We had a good, full day and everything went very well. And so it’s always a pleasure working at this office. I mean, I enjoy all the people I work with, they become my friends, and it’s a good experience. I enjoy it. Every day is good – it’s long, but it’s very, very good. And it feels very good taking care of patients.

Kevin, the last patient, in the recovery room

Dr. Delgado: How’s it going?

Kevin: Hey, doc. Glad you’re alright.

Dr. Delgado: Everything went beautiful.

Kevin: Really?

Dr. Delgado: Yeah.

Kevin: Oh thank you.

Dr. Delgado: It went really nicely.

Kevin: [Unintelligible]

Dr. Delgado: Things went well and I’m very pleased with how things turned out.

Man: We saved the best for last.

Kevin: Oh thank you, that’s great. That’s really good news. I’m good over here and your waiting room is positioned right across from the little mini kitchen. Whatever you have here, I see you eating.

Nurse: I thought about that actually, I closed the door.

[Unintelligible]

Man: Well you’ve just been recovering from 10 minutes now, I say you’re recovering pretty good.

Kevin: Thank you.

Dr. Delgado: You are.

Kevin: Yeah, I feel good. I recognize everybody.

Dr. Delgado: Yeah.

Kevin: And, I feel warm.

Dr. Delgado: You’re doing great. You’re very alert. You said some good things while you were going to sleep.

Kevin: Really?

Dr. Delgado: You remember that joke you said? When you went to sleep the other time they put you to sleep and they told you to count in reverse –

Kevin: Yeah.

Dr. Delgado: By ten –

Kevin: Yeah.

Dr. Delgado: You know how far you got?

Kevin: Eight.

[Laughter]

Kevin: The record is six. And you try to fight it. I could beat this. I could go all the way down to zero. Who do those guys think they are?

Dr. Delgado: Ten, nine, eight –

Nurse: See this pretty lady? I wanted to introduce you I thought I’d match you. She just seemed like such a nice girl I thought you two might hit it off, so. I’m Melissa, this is Kevin. Kevin, Melissa.

Kevin: How do I look?

Melissa: You look good. You look alert.

Kevin: They said I’m pretty alert.

Nurse: Yes, you do.

Melissa: How do you feel?

Kevin: Good. A little tired. Getting my bearings together.

Melissa: Yeah?

Nurse: He’s had a few martinis.

Kevin: Yeah, I was just gonna say.

Nurse: Do you wanna help him?

Melissa: Yeah.

Nurse: Okay. So you feel okay then, dude?

Kevin: Yeah.

Nurse: No nausea, no –

Kevin: No, no. I feel fine.

Nurse: Okay, let’s go then. I’m gonna take you down in a wheelchair.

Kevin: Okay. You have everything? Keys? And –

Nurse: And, let’s go.

Kevin: Let’s go. I can handle this. And, this way.

Post-Op Visits 1 and 2

Meryl: There’s always the possibility that surgery won’t turn out to be exactly the way they want to look. There’s cases of surgeons removing too much or too little. And if they’ve removed too much it’s a bigger problem to resolve, and they don’t look like – there’s a lot of people who think they’re going to look like Tom Cruise post-surgery and that’s not a realistic chest.

1st visit after surgery

2 days later

Dr. Delgado: We get to unveil things and see how things look, see if there’s any problems, see how things are healing. We’re gonna pull our drains today – that’s sometimes uncomfortable. But the most interesting thing is the patient gets the first chance to look at themselves even though things are swollen and black and blue and somewhat painful. Uh, it’s still a very interesting time, so. This is their first follow-up appointment and, uh, we’ll see them again in about a week. Starting to take out stitches and getting new garments on them, so. Uh, that’s our plan today – just get the trains out, get them cleaned up, and show them how they look.

Dr. Delgado: Everybody did surprisingly well. I got no calls – I called them all the following day and they all were doing great. No pain, discomfort. I was very encouraged. Um, no issues, and that’s the way I like it – no issues.

Colleen: Today the guys are coming in, and it’s been two days after the surgery so we’re all pretty excited to see them. They likely will be coming and walking a little bit on the slow side – probably a little sore because the surgery was pretty aggressive. The exciting part is, we take off their garments, their dressings, we clean everything off, take some drains out, and then possibly try on some new vests and get things that are a little more secure and compression – compression garments, because they still have to be real careful as far as exercise and keeping their activities low. Prevents swelling and some side effects.

Colleen: This is a very, very simple office visit. The gentleman will come on in and they’ll come to the room – it’ll take probably 10-15 minutes from the time we start taking off their garments and bandages to the time they’ll get another appointment to come back in – another possibly four to seven days.

David

David: Today’s the follow-up to our surgery that we had on Saturday, so.

David: Past couple days have been pretty good. Just been a little bit sore and just a little, kind of – sometimes it’s hard to move the way I want to move because I’m, my motion’s a little restricted. But sleep has been – you kinda have to sleep on your back, but other than that it’s been – I’m real positive about it. Looking forward to kinda seeing, uh, the results.

Colleen: Hi David.

David: Hey.

Collen: How are you feeling?

David: Good.

Collen: Good. Feel okay?

David: Yeah.

Collen: Sleeping well?

David: Somewhat. Sitting up’s not the funnest way to sleep.

Dr. Delgado: Hey, buddy.

David: Hey.

Dr. Delgado: How’s it going?

David: [Unintelligible]

Dr. Delgado: Good. No bleeding.

David: I bet you had a long day Saturday, huh?

Dr. Delgado: Yes. We all did.

David: I didn’t, mine was quick. I didn’t realize you guys did it. I woke and I was like, are you guys gonna do it? And then I looked down and I said, you know what? They did it.

Dr. Delgado: You look to be healing really nicely. Got a nice shape, nice contour.

David: Yeah, it looks really good. Looks amazing. I mean, even just right now it’s amazing, the difference..

David: It’s so different. I mean it looks awesome. In my – to me, it does. It’s incredible. I couldn’t have asked for anything better than what it looks like. I’m really, really happy. And he said that they’re still swollen, so.

Dr. Delgado: We’ll change your garment next time.

David: Okay. Yeah, that’s fine.

Dr. Delgado: You’ll get it dirty and stuff.

David: That’s fine, don’t care. Just as long as it covers stuff for the meantime.

Dr. Delgado: Okay.

David: And at least six tubes are off. You know I felt like a couple cow balls hanging off me.

Dr. Delgado: Yeah well that’s what they’re like, cow balls.

David: They are. They’re really funny. They’re uncomfortable. Thank you very much, it looks really good. I’m really excited to see the results.

Dr. Delgado: Good, I am too, man.

David: Yes even just the way they looked right now.

Dr. Delgado: You’re doing great.

David: Looks incredible. Thank you so much.

Dr. Delgado: Take care.

Jerome

Jerome: Well, my visit today I guess is to, uh, let’s see, assess and look at the outcome of the surgery, the gynecomastia surgery. And so I haven’t had the opportunity to take off the foam but I’m kind of – I don’t know, I’m just a little anxious to see what it looks like. So, it feels better.

Jerome: So I can’t do a whole lot, so I’ve just been kind of laying around and staying elevated and, uh, just taking things very slow and easy. And so I haven’t had a lot of pain, and yeah – I think it was a perfect surgery. I would say that yeah, like I haven’t experienced a lot of pain. Like, anything would be better than the way that it was, and so the fact of the matter is that living in that secret denial of just being just a little off-kilter – just a little off completeness, and so I’m just at a place that I want to see a successful surgery and make sure that the contour is good. Make sure that – because he’s the best, and so I’m believing that that’s the case.

Taking off the Bandages

Colleen: You peeked, right?

Jerome: No, I haven’t.

Colleen: See? Nobody peeks. Or I should say, rarely peeks.

Jerome: Okay.

Colleen: That’s the perfect description. Yep. Okay, so a little foam here, that’s gonna come off as well.

Dr. Delgado: How you doing, buddy?

Jerome: I’m good, good.

Dr. Delgado: How you been, man?

Jerome: I’ve been good, I’ve been good.

Dr. Delgado: Well, no bleeding.

Jerome: Oh yeah. Oh yeah.

Dr. Delgado: I’m telling you, man.

Jerome: Oh yeah.

Dr. Delgado: New you.

Jerome: Oh yeah. It’s different. I think I’m still a little bloated. My belly has gotten bigger.

Jerome: Oh yeah. You know, I never could look over the side of myself like that. I could never do that.

Dr. Delgado: Never?

Jerome: Never. Isn’t that amazing?

Jerome: I think the most painful process is what she just pulled out.

Dr. Delgado: You know, a lot of people tell me that. It’s not that uncommon.

Putting on a Clean Vest

Dr. Delgado: So we’ll change this garment the next time. I don’t want – because it gets dirty and stuff, so. Well, man, you’re just cruising right along. I mean, you’re getting there, man. I know it’s a long journey. You know?

Jerome: It’s been a very long journey there. But yeah. I’m impressed. I am, uh, I’m impressed. Thank you sir.

Dr. Delgado: You’re getting there, man.

Jerome: Thank you so much. I appreciate it.

Dr. Delgado: You’ll be on the beach before you know it.

Jerome: Okay. “Where you going?” I’m going to Disneyland. Absolutely.

Dr. Delgado: Alright, man.

Jerome: Thank you so much.

Colleen: So, no exercise, no – nothing that will increase your circulation. A lot of people will feel that, “okay, well the surgery was up top” so they’ll just do the treadmill. And, you can’t do that.

Jerome: Okay.

Colleen: It’s really nothing increase to your circulation at all in your body.

Jerome. I’m telling you. God, this is, uh, yeah.

Colleen: Good, I’m happy for you. I’m glad you did it.

Jerome: I’m glad that you guys –

Colleen: Yeah, no, we understand it. A lot of guys come in feeling deformed.

Jerome: Yeah that’s it, that’s –

Colleen: And you all come in, you all look very similar but it’s the perception –

Jerome: It’s not so much that it’s the feelings and emotions that you have to go through. It’s just a bad psychological destruction that you go through.

Kevin

Kevin: I’m back today to take out the drains. Uh, it is almost – basically three days after surgery and I think it’s just that the first of a few pre-ops – post-ops – I’m sorry. That we’ve come to see the doctor about.

Kevin: Doctor.

Dr. Delgado: Good to see you, man.

Kevin: You, too.

Dr. Delgado: Well have a seat and take off your shirt. So how’s it been the last few days?

Kevin: Um, you know, pretty good. The pain wasn’t an issue, just discomfort – you know, you got stuff kind of coming out of your body. And you got this vest on that causes some pressure but nothing completely unbearable – well I have been taking medicine, just some painkillers and stuff. Oh thank you. And, um, I haven’t looked at it and I’ve been trying to stay off my feet, but I just get too bored so I’ve been trying to do some moving around.

Dr. Delgado: Just gonna lean you back a little bit. No bleeding, thank God. Three out of three –

Kevin: Really?

Dr. Delgado: That’s right.

Kevin: Alright.

Dr. Delgado: Well now it’s just, you know, keep on the vest. You can take a shower. But you gotta let these heal up –

Kevin: Yeah.

Dr. Delgado: You know, it’s still gonna take a while yet, you’re still not there by a longshot. But you’re definitely on the road to recovery.

Dr. Delgado: This vest is your friend for like six weeks, man.

Dr. Delgado: Yeah, we’ll see you, um, Wednesday and take stitches out – all your stitches.

Kevin: Okay.

Dr. Delgado: And, um, probably another vest at that time. And then I robably won’t see you back for a couple weeks.

Dr. Delgado: Yeah, no you’re ready to rock and roll now.

Kevin: Fantastic.

Dr. Delgado: Alright, man.

Kevin: Thanks, doc.

Dr. Delgado: Bye bye.

Kevin: I feel much lighter, I feel more mobile. I’m glad that, you know, the bulbs came off and that it does look – it does look good. It’s in line with the expectations, so I feel much better. And I think it’s just only gonna get better and better as the healing continues.

1 week after surgery

2nd Post – Op Visit

Dr. Delgado: This is the second post-operative visit and, um, now that their drains are out and swelling should start to be coming down now, we should start seeing some shapes and now how the overall area is healing, how the incision looks, how the drain site looks. Um, they’re still wearing the compression garment that is going to be worn for total of at least six weeks – at least, so. Also the patients are going to get a real impact now of how they’re going to start to look, so it’s – it’s a – it’s a good and exciting time, I think, for them and me. Sometimes we’ll change their garments at this time because we want it tighter and a more comfortable garment and that’s something we’ll probably do, I think, as well. So this is post-op appointment two and hopefully they look good.

Jerome: I’d say it’s been very good the last couple of days or less – since the last time I was here – was last Wednesday. It’s been very, very, uh, enlightening to experience watching things as they settle in and watching the difference in my body and the contouring that’s been taking shape and, uh, I’m very impressed. It’s very, very flat – much flatter than it was, and so, uh, so it’s a dramatic change.

Jerome: My expectation was – this far exceeds my expectation.

Dr. Delgado: Hey, Jerome.

Jerome: Hey, doc.

Dr. Delgado: How’s it going?

Jerome: I’m doing very well, thank you so very much. Just doing very well.

Dr. Delgado: I like this homemade foam you got going here, man.

Jerome: Yeah, isn’t that something.

Dr. Delgado: Well, I’d like you to take everything off. How you feel?

Jerome: I feel good, I feel really good.

Dr. Delgado: The pain and stuff is reasonable –

Jerome: Every now and then, I – you know – because I’m weaning off of the Darvocet. I’m trying to.

Dr. Delgado: Yeah, get off that – Tylenol’s good. Looking good there, man.

Jerome: I know, I’m impressed. Yeah. I’m impressed.

Dr. Delgado: That’s really good.

Jerome: I’m impressed. I sure am.

Dr. Delgado: That skin’s coming down.

Jerome: Yeah.

Dr. Delgado: You got some fluid there, though. Have you taken off the vest at any time? This is an example of fluid, as you see here. So you can see there’s a wave in there, so. What we’re gonna do is stick a needle in there and pull out the fluid. You wear that garment, man. At all times.

Jerome: Okay.

Dr. Delgado: You haven’t been cheating, have you?

Jerome: No, actually –

Dr. Delgado: You can tell the doctor, now.

Jerome: Well actually, you know what, it got a little uncomfortable one night and I just said – you know, I kind of took it off maybe about an hour or two –

Dr. Delgado: Uh-huh.

Jerome: Yeah.

Dr. Delgado: And when did that fluid come up? Do you have any idea?

Jerome: I can’t really say. I, uh, I noticed it two days ago.

Dr. Delgado: Okay. You can tell the doctor the truth.

Jerome: Absolutely.

Dr. Delgado: I’m here to help you.

Jerome: I don’t want to tell you any lies whatsoever – no, not at all.

Dr. Delgado: God knows –

Jerome: You can’t hide from him.

Dr. Delgado: I think we’re gonna switch you to a different garment, too.

Jerome: That’d be a wonderful thing. That one is so noticeable.

Dr. Delgado: It’s noticeable and it’s just a lot more uncomfortable.

Jerome: Yeah.

Dr. Delgado: The fluid’s not a problem – it’s not going to be a long-term problem at all. The only thing is, is sometimes it will take a few times of tapping this fluid out to get it to go away completely. Relax now, yeah. We’ve got a little bit more swelling here in the area and this has to spill out and that fluid will be in there.

Jerome: I’m just so used to sleeping on one side you can’t do that and

Dr. Delgado: You can, if you want. Well if it –

Jerome: I was concerned about that. I think that maybe it’s just – I tried to sleep on my side one night and it just was a little uncomfortable. I was thinking that’s maybe where that fluid came from, so that’s what I was thinking.

Dr. Delgado: Oh, you had gone to sleep on that side – that side down –

Jerome: Yeah, so –

Dr. Delgado: Sometimes if you’re sleeping on one side after surgery, the fluid will tend to pull on that side. Um, but this is a, a well known complication after any kind of surgery that drains are used where the the fluid accumulates after it is pulled out.

Jerome: Okay.

Dr. Delgado: And so, that site is gonna be behind a little bit than this one – behind the healing curve a little bit but not anything substantial.

Jerome: As I was saying earlier, I’m just – I’m just totally impressed with the overall result. I was more than – it surpasses my expectation level, you know.

Dr. Delgado: That’s nice to hear.

Jerome: And so yeah.

Dr. Delgado: Well hopefully this spring time you’ll be out there.

Jerome: I, yeah. I’ll be out there. I will be. I’m hopeful.

Dr. Delgado: I’ll be right back in, okay.

Colleen: Alright. So this vest – I know, this’ll be nice. So this one needs to be worn for the next five weeks.

Jerome: Okay.

Colleen: Okay? You can have it on for longer but ideally, wear the other one when this one’s not good any longer. Let’s get your steri-strips on. And you can just reapply right over the top.

Jerome: Okay.

Collen: Now take –

Jerome: Yeah.

Colleen: Now that should be a little bit snug there. Go ahead and take the bottom, see if we can get that zipper in. Gotta pull from – we need to give it a little pulling from around the edges. I know they’re tight.

Jerome: Sure this is like, uh, this is –

Colleen: It’s like a test, isn’t it.

Jerome: No, I can’t get this. This is not good.

Colleen: Okay, there you go. Okay. Now the other part that he likes about this over the other one, is it does go up high into the armpit. He wants it like that. So what you don’t want to do is, you don’t want to pull it down to get it so that this is coming down to far. He wants it up there. But what we want to check is to make sure that this isn’t too loose, because it should be snug – you know, you’re feeling it down here – it should be that way all up in here. So sit back for a moment. I’m gonna tell him you have it on.

Dr. Delgado: But it fits you pretty good, man. I think you’re good. So, uh, you know, also keep this – pull this down so it doesn’t give you wrinkles here.

Dr. Delgado: Alright, man. We’ll see you then. You look good.

Jerome: Thank you so much.

Dr. Delgado: You’re coming along.

Jerome: Alright.

Colleen: And no exercise. So don’t overdo it with your arms – that’s what often causes the swelling. You know, the fluid accumulation is too much too soon, so even though you may feel better, don’t start doing too much. That’s a solid four to six weeks of no exercise.

Jerome: Okay.

Dr. Delgado: Patients look great. Um, no bleeding whatsoever which is what I really like the see because that’s what I see most often, um, with these kinds of aggressive treatments. But everyone looked excellent, the shape looked great, all the incisions were healing well. Jerome was – I was concerned about it at first because of the superior incision, but you know he’s healing beautifully. Um, so again I’m very optimistic. Everything’s swollen, we have to wait for that to come down, you know. I don’t want any of the men to be too optimistic and start working out or doing anything crazy too soon, um, but everything really looks good. I’m very, I’m very pleased.

10-Day Follow-up visit

Dr. Delgado: So, we’ll put you in a garment today and, um, take out your stitches, and probably I won’t see for a couple of weeks, you know.

Kevin: And that – that next appointment is to just again – just to keep track of it?

Dr. Delgado: Yep, look at how you’re healing, how things are coming around. It’s – the appointments get fewer and fewer.

Kevin: Yeah.

Dr. Delgado: Unfortunately. I miss you guys.

Kevin: So then in terms of meds I’ve pretty much used up the medication, the antibiotics. I don’t need to refill or anything? Medications –

Dr. Delgado: No, man. You’re getting beyond the curve now.

Kevin: Well that’s great.

Dr. Delgado: That’s good.

Kevin: So just take this whole thing off?

Dr. Delgado: Yeah, let ‘er rip, man.

Kevin: Is this the last time I’m taking this sucker off?

Dr. Delgado: Maybe. It’s like opening a Christmas package.

Dr. Delgado: Yeah, that looks great.

Kevin: Does it? I mean the flatness is definitely huge –

Dr. Delgado: Awesome. Looks pretty good – it looks great, man. Let’s take some stitches out.

Kevin: Alright.

Kevin: What is this, is this iodine? This discoloration?

Dr. Delgado: No that’s just bruising disseminating.

Kevin: You want to be extra careful –

Dr. Delgado: Yeah.

Kevin: So when I’m in the shower I’m like barely touching it, and I’m kind of , you know, still kind of shy about it.

Dr. Delgado: That’s okay, man. I think that’s okay. That’s alright.

Kevin: The problem when you get a flat chest is it makes this look –

Kevin: I’ll work on that.

Dr. Delgado: Good. The other – the other thing – there isn’t the stigma of a guy with a gut. The chest –

Kevin: Yeah, you hear it all the time, yeah.

Dr. Delgado: I mean, that’s not anything – you know, men don’t have as much problem with that.

Dr. Delgado: Yeah, you, um, for the, uh, for the degree of gynecomastia that you have – had – you’re gonna look great.

Dr. Delgado: We’ll see you in two weeks – two weeks and we’ll start talking about the scar management and that type of thing. There’s some things we use that I think you should just start them.

Kevin: Okay. So it looks good, huh?

Dr. Delgado: Excellent.

Kevin: Thank you, doc.

Dr. Delgado: Excellent.

Kevin: Thank you very much.

Kevin: I feel that quite a bit of relief. It gave me some relief to know that the doctors looked at the progress and feels that it’s coming along very nicely and I would say, you know, that was a big step – is that the first time the doctors seen it after taking out that – the bulbs and so, yeah. I walk out here even more comfortable than I did walking in here.

SIX-MONTH FOLLOW-UP INTERVIEWS

Kevin: I feel good. Um, it has been a little over six months since the surgery and I would say from month three on, I really felt that I was coming back to normal, and – and the further away from the surgery, the  more I feel that I’m more back to normal. Like it feels like it’s been years since the surgery.

Kevin: In terms of marks and – and, you know, from the blind eyes that are looking they have no idea that surgery took place, so.

Interviewer: Tell us about the surgery experience itself.

Kevin: Well, you know, the anticipation of the surgery is by far the worst part of it. I kind of came to, no pain. The nurse was right there. Actually, she said I was making a few jokes right away and so I felt that – I felt pretty good at that point on. And through the support of friends and my girlfriend that first week or two, you know, you do have some – some bulbs in you and you have some blood flowing. You have to kind of maintain – yeah – maintain and clean up. And so I think it was great to have people there, especially my girlfriend, to be there to help because it would’ve been – I’m sure it would have been a little bit more difficult after, doing that on your own, so. So with that support and no pain it was – it was fine.

Kevin: Best part is, now knowing that it was completely successful and I feel good about it and I look at it I’m like that – that does show a big difference for me. Confided in a few close friends and both of them have seen obviously see me before and right after – and then since then – and I think they’re very happy, says it looks good, you know. Like yeah, that was something that they were joking around before they, they knew it was kind of something that was part of me but didn’t feel like it was that much of a big deal for me because I never really opened it up, but. But they definitely after seeing the difference are like “wow, it looks great” and I think having that past me now done and then looking at me in a different light.

Kevin: I mean, I feel – I feel like yeah, it’s normal. It’s the way it should be.

Looking At Before and After Pictures

Meryl: Now as you look at these before and after pictures, how does it make you feel?

Kevin: They look like breasts – they, you know, they – from the nipple area just to the contour, it – they just. I would look at it and go “oh geez, that’s – that’s not normal.” It’s just – it’s, it’s just amazing. I would – how much has changed.

Meryl: If you today can look at this picture of you before, what would you have to say to that person?

Kevin: I would say with very little pain and the right doctor and the right strategy about it and talking it through with people, um, it would change them quite dramatically without a whole lot of risk, really.

Meryl: Kevin is a remarkable young man. He’s gone through this experience as well as anyone can possibly go through it. I think he had realistic expectations going in, and I think he’s really delighted with the outcome. And I think that his gain in self-confidence and his lack of self-consciousness about his body is really serving him well. It’ll only continue to grow better as he gets further and further away from the surgery experience and experience of having breasts.

Meryl: I think that he’s pretty normal in that he’s testing his limits around taking his shirt off like the first time at the swimming pool with the other guys. I think that just that freeing experience is walking away –  walking out of the shadows of hiding and that he’s just beginning to open up and really relax.

David: I feel a lot better about my body and stuff. It looks – I’m much more comfortable with my chest. You know, it’s uh – I’m able to – I mean just little, you know, little things you don’t even think about but I’m able to go swimming.

Interviewer: Tell me about the surgery experience.

David: It went real – I mean lot smoother than I could ever think any type of surgery could go. Just, I mean Dr. Delgado and staff, I mean, they’re really good at what they do. Got an IV in, the next thingI woke up and I was all bandaged up. I’d say the worst part was probably when they took those, those – the drainage tubes out. I almost passed out or something, I don’t know. I started getting all hot – it’s like “hold on” and you just feel like this snake thing coming pulling out of you and you’re like, it’s such a different feeling.That’s what was probably the most uncomfortable.

David: What I like about them is they’re very sensitive to the condition, very understanding. You know, not only just, you know, the doctor but the whole staff and everything like that, you know. And so, because this is kind of something that’s really, really embarrassing to guys.

Looking At Before and After Pictures

Interviewer: You recognize that picture?

David: Mm-hmm.

Interviewer: What comes up in you when you see that? It’s a picture of you before.

David: I just don’t like the way it looks. You know, just – I don’t know. I used to get so angry, you know.

Interview: So, anger?

David: Yeah, yeah. It makes me mad I just –

Interviewer: Say more about it.

David: I don’t know, I just – I’d get pissed off that, you know, that it looked like this. This, to me, is remarkable – just how much different it is.

Interviewer: What is the feeling that comes up when you look at the post-surgery?

David: Makes me happy. You know, at least I don’t have to wake up every day, you know, concerned about the way my chest looks, you know. I don’t if I can describe it other than it’s like, a life-changing event.

Interviewer: Is there any way it has changed your life other than what we talked about?

David: Everything. You know, it’s like I said – it’s a life-changing event. Something that impacted my entire life, every little aspect of it. Everything. Everything about my life has changed.

Meryl: David has clearly made a good recovery. I got the sense that he has actually experienced a lot of relief from the gynecomastia surgery and at least that piece of the shame isn’t weighing him down anymore. He’s actually made a lot of progress really being much more open and in terms of really moving past the shame of that piece of it quite nicely. I think in terms of the gynecomastia this has been a huge weight lifted off of his shoulders, and it’s actually impacted him quite positively.

Jerome: The day of the surgery was a little scary. I didn’t know what to expect. I had a friend with me, he was my support, and so. What if there’s a, you know, what if there’s a glitch, you know. And so I had those kind of fears, you know. I called my buddy a couple of hours after the surgery and I said, “man, this is a friend of mine.” I said, “I’m flat.” But the nurse had told me that day, she said “yeah, looks very flat.” And so, I just went off her word and I said, “look I’m totally flat” and I just started crying. And so, weeks later after they had taken off the bandages I was totally impressed. There was a huge difference and I can actually see “wow wow wow,” see what I mean?

Jerome: Upon completion of this whole surgery, I said “well, whatever happens, it’s got to be better than what it was.” And so as a result of that, is that I get – I feel better, I look better, there’s some – there’s some esteem and self-worth that comes along with completion of the surgery. He did a great job – at 49 years old, I’m like a kid all over again. So it’s like a second childhood. That childhood that no nobody can tease me about that anymore.

Jerome: That freedom feels like – it’s like I’ve been choked up in an area, like with an elastic band and to be able to walk in this freedom now is like the band has been loosened and – I can finally walk around on a hundred – and I hated the heat – I love the heat today. I love going into the swimming pool.

Interviewer: Yeah.

Jerome: I like jumping into the pool and just being myself.

Interviewer: So I’m gonna give you a picture of you before.

Jerome: Wow. Yeah.

Interviewer: What’s it like, looking at you before now?

Jerome: Well this is the severe piece, especially after the weight gain, but it was somewhat like this even when I was cut and chiseled. There was always some protrusion.

Interviewer: You could never really see the work that put in on your chest?

Jerome: No. No no no no no.

Interviewer: And so, if you could say something to that person, what would you say?

Jerome: To –

Interviewer: Now, knowing what you know.

Jerome: That it was alright anyway. It was alright anyway. That God doesn’t make any junk, and that, uh, even today it’s, uh. Yeah, as a result of those years of not really accepting myself because of what I didn’t like about me, it’s still – I’m still in the process and so. I would tell this person that you’re alright – you were okay. And that all we needed to do was take some risk and we’d find that we weren’t the only ones that suffered from that condition. So, wasted a lot of years – wasted a lot of years in shame and shame-based thoughts and thinking.

Interviewer: Say more about the shame. Shame is the big issue for men –

Jerome: So the shame – the shame of not being able to go out in public, to wear a tank top, to go into the swimming pool, to hang out at the beach, because of the fact that I was afraid of what the comments would be like. And so, even though I wouldn’t – I would never see those people again, I was afraid of what the comments would be like. And why was I – why did I have all the fat around my chest, how come I couldn’t be like him? And so it was always that mindset: yeah, if I was cut – I’d like to be like that person. And so today, what’s different is that I’m beginning to be okay with myself on a daily basis continuing, to get into mindset of “I love you.” “I love you, man” because it’s to learn – you know unlearning some learned behaviors, if that makes any sense.

Interviewer: So what I’m hearing is that there’s some real compassion for this guy.

Jerome: Oh yeah. He’s a good guy, yeah. Good guy. And all his feelings were always bottled up. Bottled up and you’d never know it.

Interviewer: It’s amazing how simply making that one change has given such license to be alive.

Jerome: Well it gives – it gives a little bit of life –

Interviewer: Yeah.

Jerome: To a, uh, seemingly hopeless situation. Wow. It’s a total difference. Total – T- Total diff – my God. It’s a total difference. Sure is.

Interviewer: I want you to see both at the same time to really get –

Jerome: Wow.

Interviewer: Where you were, where you are.

Jerome: Wow. So what that brings up for me is what would have been like it had I been normal like this guy, yesterday.

Meryl: Jerome has had a remarkable experience. It’s had been nothing short of life transformative for him. He’s really delighted with the results of the surgery and he has allowed himself to really begin to expressing himself in a new way, and this couldn’t have come at a better time for him, nor – and I think that even he doesn’t understand yet the ramifications of how much this is this going to change him being in the world. He’s really, uh, really best possible outcome, I think from a psychological perspective, in terms of framing him up to do other things in his life and to focus on other things and to really just thoroughly enjoy his body and being in the world. It’s just a marvelous experience for him.

FINAL THOUGHTS

Kevin: A little over nine months now since the surgery and I feel great. I feel that the surgery was years ago – it doesn’t seem like I can think about it this – was within the same year, just because I feel, that body-wise, I’ve developed pretty nicely. I feel that, you know, it’s pretty much over. I’m kind of moving on past it. I feel that it has taken away a good piece of what my thought has been about, you know, myself and the body. I think it’s been overall great – a great and really painless process.

Kevin: I would recommend the surgery. I would recommend Dr. Delgado, as well. It really would not be any hesitant of me to recommend this type of surgery – obviously does take a little time away, you know. You do have to take a few days off. And, um, but in terms of, you know, the risk factors and in post-surgery feelings, there’s really nothing bad to say about.

Jerome: It’s been a year now, and so what has happened as a result of that surgery is that, you know, I feel a sense of freedom that I’ve never had before. Freedom to be able to take my shirt off and go wherever I want to go without the feelings of embarrassment or shame or condemnation or being laughed at. And so I had no idea what to expect, but mine was definitely a success. And so what has happened as a result is I’ve started lifting weights and so I’ve kind of got some of my body structure back and put on a little weight this time around, but that’s okay too, because it’ll come off. And so, yeah the surgery was definitely a success.

Jerome: Yeah, I would definitely encourage that, too, for anybody that was actually going to even think about a surgery like that. If you’re thinking about it, it’s probably something that you need to do and so, like I said, mine wasn’t as severe as I’ve seen some others, but it’s definitely made it – I’ve had some dramatic changes in my life as a result of this surgery so it was definitely a success.

David: You know a few months ago I had the surgery with Dr. Delgado and it went really well. I mean, amazing how well it went. Amazing how kind of, I guess, easy it was, in my opinion, how, you know, you went in – very, very caring staff, helped me out with everything. Had surgery, woke up. You know, didn’t have too much pain, just a little uncomfortableness, if you would. And, you know, it seems like a few, few – it seems like I was a lot better like within a few weeks. More in the last year or in the last six months after the surgery around people than I have probably in the last 10 years. Just because I feel a lot more comfortable with myself and the way I look and stuff. And before, I would never, never take off my shirt. It’s kind of like a whole new, whole new way of living. I don’t – I don’t really have to be scared of anything like that, you know. Every once in a while I’ll take off my shirt and I still kind of feel like “oh.” But I know things look a lot better now so I’m not so uncomfortable by it. It just really helped me out a lot, so I’d recommend it to anybody who’s, who’s considering having the surgery done and anybody that’s struggling with the condition. You know, aside from the physical aspects of what it can do to improve the look of yourself, the emotional aspects are what, what really it’s helped me out with, so. I’d recommend it – highly recommended to anybody