Instant brawn
Frank (not his real name) is talking from New York City (not his real home) about his chest (not his real muscles).
When Frank was a kid, he felt skinny, that his chest wasn’t big enough. Even after four years of swimming for his university, it wasn’t big enough. Even after lifting weights for the past 20 years, it still wasn’t big enough.
“I got compliments on my arms, legs, back, everything but the chest,” said the 5-foot-9, 180-pound investment broker. That changed about nine months ago, however, when the 49-year-old Hollywood resident decided to get pectoral implants. It turns out the pair of palm-sized, solid silicone discs were enough.
“I’m like a peacock strutting his feathers,” said Frank, who wanted to remain anonymous because friends don’t know he had the procedure. “I feel more positive about myself than ever and I’m not self-conscious anymore about wearing an open shirt. I’ve got nice cuts. I like the way I look.”
As American men confront a barrage of images of pumped-up male perfection, plastic surgeons across the country say that a growing number are willing to pay anywhere from $4,000 to $10,000 to put in what God, genetics or exercise left out of their chests. Precise statistics on the number of pectoral implants, or “male chest enhancements,” performed in the United States are unavailable because the trend is still young. Many plastic surgeons expect pectoral implants to continue to rise in popularity for a variety of reasons. The procedure’s best sales pitch is transmitted across the cultural landscape where chiseled masculine chests are displayed on everything from fitness magazines to underwear ads to Hollywood action heroes.
And the bulking up has not been limited to mere fantasy. Today’s professional athletes, especially in major sports such as football and baseball, are bigger, stronger and more muscular than a generation ago. Michelangelo’s David has been crushed and replaced by the Rock.
“Give it five years, you’re going to see a lot more pec implants,” said Roberto Olivardia, a Harvard psychiatrist who co-wrote “The Adonis Complex: The Secret Crisis of Male Body Obsession,” which concluded that a growing number of men feel shamefully ugly because they consider themselves to be too fat or too underdeveloped muscularly. “Men are being targeted by the media and advertising with the kind of images that women have been bombarded with for years. And like women, it’s making men dissatisfied with their bodies.”
Another possible reason for the growth in pec implants and other cosmetic procedures in men is that baby boomers tend to place a high premium on a youthful, fit-looking appearance and seem to have more trouble adjusting to the aging process than previous generations, say plastic surgeons. Not only do workers feel the need to dress for success, but increasingly their bodies must reflect that credo too. Another factor is that most cosmetic surgery is relatively uncomplicated and can be performed in outpatient clinics.
Last year, nearly 1 million American men elected to have cosmetic surgery, a figure that represents almost 15% of the overall plastic surgery market, according to the American Society of Plastic Surgeons. Twenty years ago, today’s top five surgical procedures for men -- nose reshaping, liposuction, eyelid surgery, hair transplants and breast reduction -- were virtually unheard of men.
Seeking ‘a quick fix’
“Men want to achieve that magazine look [in the chest], and if they can’t do it through discipline, they’ll try it through other means,” said Dr. Josh Korman, a plastic surgeon in Mountain View, Calif., and a clinical faculty member at Stanford University Medical School. “People want a quick fix.”
The original demand for pec implants came from bodybuilders in the early 1980s. By that time, the 1977 documentary “Pumping Iron,” featuring Arnold Schwarzenegger, helped to fuel a nationwide surge in the sport. Despite their exhaustive hours in the gym, some bodybuilders soon discovered genetics were imposing limits on their muscle size.
Today, it’s not just bodybuilders who want a larger chest. Models, personal trainers and actors are among the most likely professionals to seek the procedure, say plastic surgeons. But even men whose livelihood doesn’t depend on working shirtless -- car mechanics or attorneys, for example -- have gone under the knife to expand their chest size. While the surgery has been performed all over the country, the majority of procedures are done in Southern California and Florida, according to plastic surgeons.
“The general population is interested in implants now. They don’t want to look like a bodybuilder,” said Dr. Adrien Aiache, a Beverly Hills plastic surgeon who has designed his own line of pectoral implants. “They want to look more macho.”
The opaque-colored implants are made of pliable but solid silicone -- a different composition from breast implants for women, which are typically filled with saline. As one plastic surgeon put it, if a female breast implant is a 2 on a hardness scale of 1 to 10, the male implant is about a 5.
The implants, which come in a variety of shapes and sizes to fit the contours of the male chest, are tucked under the pectoral muscles by one of two surgical methods. First, in the endoscopic method, a long, thin tube cuts through the crease of the armpit to the chest. Through this mini-canal, the camera-equipped endoscope places the implant into the chest. Or, in the traditional method, small incisions can be made just under the armpit -- almost never through the nipple, which leaves considerable scarring -- and the implant is inserted. The procedure typically takes less than two hours and is usually performed in the doctor’s office under general anesthesia. Patients often can go home about two hours after surgery and are instructed to remain in bed for 24 hours. Normal activities can be resumed within a week and patients are advised to wait at least six weeks before returning to vigorous physical activities.
Risk of complications
Implant surgery comes with roughly the same risk of complications for men as it does for women, according to plastic surgeons. Excessive bleeding or fluid buildup around the implant can occur in 1% to 2% of cases. Infections can also occur in 1% of cases, and may require the removal of the implants.
Also, there’s a slight risk of displacement. For various reasons, the implant may shift, which could require another surgery to correct.
“The implant can move and flip,” said Korman. “Gravity is still gravity.”
After a full recovery, of course, the question becomes: Do they look real or fake? If the job is done properly, it’s very difficult to tell, even for a plastic surgeon, doctors said. The only reliable indicator would be scars, and those are near the wrinkle of the armpit and difficult to detect, they said.
However, once a man has had implants, they are usually in for a lifetime, unless he chooses to remove them. That means a man must maintain his musculature to conform to the implant. Otherwise, the chest and arms or back will look out of proportion.
“It can be overdone,” said Dr. Francis Palmer, a Beverly Hills plastic surgeon. “If you have a nice, well-defined chest and you’re totally slovenly everywhere else, then that might be a hint you’ve had some help.”
More than any physical or cosmetic risks, however, the surgery in some cases can indicate a poor self-image that the procedure is unlikely to heal -- no matter how good the patient’s pecs may look afterward, said Olivardia. “I don’t think cosmetic surgery is a bad thing.... “ he said. “But I get concerned when people place too great a stake in what pec implants will do for them, when they think this surgery will make them whole. That’s when it’s problematic.”
The point is buttressed by the apparent embarrassment men feel regarding their surgeries. Several plastic surgeons who were asked to contact patients for this story reported that most patients were highly reluctant to disclose their experiences.
“There’s no doubt there’s a strong social stigma for men,” said Dr. Gregory Mueller, a Beverly Hills plastic surgeon who says he has performed about 250 pec implants in the past four years. “They are very guarded about talking about it. Women are much more open about their surgeries.”
But just how popular pec implants may become is open to debate. While bodybuilders may be frustrated they can’t develop individual pecs the size of a phone book, the average male with more modest ambitions has a viable option to surgery -- pumping iron at the local health club.
“I tell [potential implant clients] they should start in the gym,” said Korman. “A woman cannot make her breasts any bigger. But a man can make his chest bigger by exercise. You just have to do it.”