By Pheroze Khareghat
Unfortunately when people gain weight they can’t choose where the extra pounds go. While a woman may be psyched to add some fullness to her chest, for a guy it creates an often embarrassing phenomenon - man boobs. Some refer to them as moobs, but they are no laughing matter.

This problem is especially severe among hostel students. “Life is not easy for a guy with big breasts,” says Rajesh Sharma (name changed) who underwent this surgery two months back. “When I was in school one of my friends commented, ‘look, that girl has great boobies,’ which was enough to sow the seeds of an inferiority complex in me.”
And many guys cringe because they have chests that jiggle and bounce. It is not a new phenomenon and in Indian villages it is a condition that is laughed at as the sufferer takes bath in the temple tank. But today the scene has changed. Nowadays a male between the ages of 20 and 40 feels psychologically affected walking on the beach in swimming trunks. This is a way of looking hunky he would like to avoid. The only alternative would be to wear Hawaii shirts or some loose garment that would hide this problem.
In fact it is a millenniums old problem as statues of the ancient Egyptian ruler, Pharaoh Seti I of the BC eras show enlarged breasts. Sure they are stone breasts, but that is probably what the Pharaoh looked like in life. Aristotle reported encountering this problem, among all those handsome ancient Greeks, while the oldest description of the surgical removal of male breasts is found in the writings of Paulus of Aegineta who lived from 636 to 690 AD.
The medical term for this is gynecomastia. Modern day men, however, make the gynecomastia problem grow “larger” by taking anabolic steroids for weight lifting and using some illegal drugs, most notably marijuana. Another reason is a hormonal imbalance during puberty. In fact, this can happen up to 40 per cent of teenage boys. This condition will disappear in 90 per cent of these boys within 3 years or less.
Other reasons are side effects of some prescription drugs or some diseases of the hormone system of the body. And there are yet other reasons, like the reaction to high dose ulcer medicines. Gynecomastia can also run in a guy’s family. The appearance is caused by a combination of dense breast tissue under the nipple and fatty tissue over the pectoralis major muscle - that broad, flat muscle that runs from the armpit to the sternum and from the collarbone to mid-chest.
Many men across the country have enlisted plastic surgeons to use liposuction to vacuum out excess fat and then sculpt and lift breast tissue to form a toned look. Some even fold skin over the areola to decrease the size of the nipple area. But surgeons opine that this is no longer a cosmetic operation and that the operation should be undertaken only if there is a great necessity. Sometimes a surgeon can take out the chest flab with liposuction alone. At other times surgeons must use a little more surgery to remove the more firm breast tissue. But nobody wants to look like as if he has been in a bunch of knife fights. Because of that many surgeons go into the chest through an incision made at the edge of areola. And that hides the scar
Senior cosmetic surgeon at Mumbai’s Beach Candy Hospital Dr Mohan Thomas said that out of every 1,000 men who consult for male breast reduction at least 160 actually go under the knife. “It’s undoubtedly on the rise. I will put it at 40 per cent annually. Men want to look good, which is possible only if every curve of your body is maintained the way it should be. And shirt is something which you want to take off carefree. An unusually increased breast area is certainly a cause of worry for men who go to salons for bleaching, slog at gyms, visit spas, or who are associated with glamour industry,” said Dr Anup Dhir, senior cosmetic consultant at the Apollo Hospital Hyderabad. In 2003 there were only 22 male breast reduction operations in Mumbai, but the number jumped by nearly 15 times to 323 in 2009.
 “The reasons vary from individual to individual but in most cases it is professional pressure, the knowledge that it is a painless procedure and attending several Indian religious rituals that demand a man to take his shirt off,” said Dr Thomas, who is also founder of the Indian Society of Cosmetic Surgery.
The surgery depends on the amount of fat deposit and the level of drooping in the chest area. There’re three grades of operation. Grade one (where drooping is less) can be addressed by a minimal access two-hour surgical procedure with high definition liposuction and local anaesthesia. If the dropping is more and the nipples appear smaller then a combination of liposuction and minimal access surgery is done, which normally takes three hours. It comes under grade two.
Grade three cases are where drooping is or more than one finger plus. This requires an extensive surgery involving removal of skin in the area. Though the patient can return to work in a day or two, the number of resting days may vary from a day to five days. There’re also certain restrictions. According to cosmetology  surgeons at least  twenty males every month  in each of the major metros go for  this kind of beauty correction that costs anything between Rupees 40 thousand to 80 thousand depending on the size of the “problem”. MF