Let's be clear. As a guy, growing up with puffy nipples sucks.
Everyday before entering the locker room at school during my teenage years, I would pinch my nipples. The left one first, then the right one, and I'd wait until they were both erect before turning around to face people. If the room was cold, I'd have about a minute until my body adjusted to the temperature and my nips set back into place. If the room was warm, about half that time.
When they did relax back into their original form, I'd have to turn away from my peers, quickly swipe my hands across my chest, and then wait until the illusion returned. Of course, this would only work a few times before my body caught onto the trick and my mammary glands stayed permanently puffy. Thus, all of my changing, deodorizing, and general hygiene needed to be done in a short, two-minute window, unless I wanted to be laughed at for having deflated marshmallows on my chest.
The condition I had (and still have to some degree) is called gynecomastia, and it's actually a pretty common trend among young men when going through puberty, although it sometimes persists afterward.
Characterized by the development of breast tissue both in and/or around the nipple, gynecomastia is oftentimes much worse than I had it. For many men with the condition, actual big, honking breasts begin to develop on their chest. For me, I just had a bit of puff in my nips that made me embarrassed to take my shirt off.
The cause of breast development in men really can't be narrowed down to one specific source, but we do know that there are a variety of factors that can contribute to it. These factors, such as high estrogen levels, misuse of anabolic steroids, and long-standing deposits of fat from childhood are all generally considered the most common ways in which the condition develops, but sometimes men develop breasts in mysterious ways.
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In 2013, a study found that German soldiers who performed the time-honored military tradition of slapping a rifle against one's chest during ceremonial drills began to notice breast growth on the side of the chest that was being impacted. Interestingly, the other side stayed normal, suggesting that physical pressure may be able to stimulate breast growth.
The research concluded that the only effective treatment for the soldiers' gynecomastia was breast reduction surgery, but for many men suffering from the embarrassing plight of cream puff-looking nipples or bulging breasts, the idea of being cut open for a largely-cosmetic reason is a hard pill to swallow. It certainly was for me, and it wasn't until very recently that I became comfortable with my nipples being slightly puffy.
Prior to my 18th birthday, I had attempted to cure and cope with my gynecomastia in a number of ways. Growing up as an overweight kid, I figured that starting weightlifting and losing the flub I gained from years of slamming back donuts and Goldfish crackers would be enough to kill my nipple problem for good. After developing an athletic build, I found that, low and behold, I still had loose lumps hanging off my now lean chest that made the average person gawk.
I also tried to fine tune my diet to eliminate phytoestrogens and BPA—chemical compounds that have been linked to gynecomastia onset and recurrence. I made a conscious effort to cut out soy products, to eliminate my use of low-quality plastics, and to stop using hygiene products with particles in them. On top of this, I increased my intake of saturated fat and other healthy lipids to encourage balanced hormone production. None of these things helped.
At one point, I become so frustrated with not being able to go to the beach without having a panic attack that I began to research makeshift methods of keeping my nipples erect. One of the methods I found online suggested buying a bottle of liquid bandage and spraying it onto my nipples after they were hard. This, shockingly, did not work and just made me feel like an idiot.
Another method recommended buying a chest binder to hide the outline of the nipples under a t-shirt, but since I didn't have actual breast tissue surrounding my nipple, I felt this was kind of extreme and decided to pass on it. Many sufferers of gynecomastia employ this method, however, even going as far as buying chest-binding compression shirts.
There's also the various environmental and social factors you have to be aware of. For example, if it's cold outside, you're in luck! You can walk around shirtless and not have to worry about your nipples being anything less than diamond-cutting hard. People will genuinely think your nips are just like anyone else's. If it's warm out, though—like in that horrible period known as "summer"—be prepared to think of a rotating series of excuses as to why you're not stripping down to your swim shorts and diving in the pool like the rest of your friends.
Coping mechanisms aside, I think it's safe to say that any man who has a problem with their breasts is eventually going to consider the idea of surgery—I certainly did and got close to actually going through with it numerous times. After all, not everybody can go on wearing baggy shirts and skipping the beach/pool scene forever, especially when growing up in an age where the fear of missing out is a clinically-defined phobia.
And the statistics show a rise in men who are choosing to slide under the knife. With a 33 percent increase in male breast reduction surgeries being reported by the American Society for Aesthetic Plastic Surgery (APAPS) over the past five years, breast reduction in men is becoming more common than ever.
According to Toronto plastic surgeon Dr. Frank Lista, most men he sees come in with the same concerns I've had throughout my life—being that of general embarrassment and humiliation. He does add, however, that most men will never achieve the perfect image they're looking for, even with good surgery.
"What [patients] say is that I've had this all my life, I'm embarrassed about it, people make fun of me, and I don't want to take my shirt off. I need this gone," he told me. "You have to ask, do they have a realistic expectation of how they're going to look? If somebody who has severe gynecomastia is looking to look like the cover of Men's Health, then you could do an excellent operation and still have them end up disappointed."
Lista, riffing off my laughable mention of spraying my nipples with bandage in a bottle, said that he has seen men come in with all kinds of DIY remedies, ranging from herbal medicines to hormonal inhibitors such as Nolvadex. He notes that while some of them can help, none of them last forever.
Despite all the patients Lista sees at his clinic, he tells me only a small few have unreasonably high expectations of their body. With that said, he notes one of the serious risks of presuming surgery is a cure-all: that body image problems in men, such as body dysmorphia, are largely overlooked and that there are oftentimes deeper-rooted issues that can be glossed over.
"It's important to know if [the patient is] emotionally stable. Some people have an emotional overlay that exceeds what can be actually accomplished with the surgery. If somebody says, 'I can't get a job because of this,' or, 'I can't find a girlfriend because of this,' then there is a deeper issue that is probably not going to be resolved, even after surgery."
The irrational fear that Lista spoke of is something I lived with for a long time. For many years, I was physically unable to complete tasks while wearing a tight shirt. In fact, my wardrobe selection for the day would fundamentally determine how sane I was going to be, and if I wasn't able to find a loose shirt or something to mask the outline of my nipples, I would skip appointments, class, work. Just about anything that would put me in a social situation.
There are some tasks you really can't avoid without stripping down, though. Before getting laid for the first time, I genuinely believed that girls were going to lose their shit, put their clothes back on, and dip once they saw my inflamed chest-danglers. On a number of occasions, I bailed at the last moment or made up excuses as things were getting hot and heavy. When I eventually lost my V-card, the girl I was with asked me why I didn't take my shirt off. I laughed awkwardly and told her I was cold.
As time went on and my condition got less severe (like it does for most men exiting puberty), even the slight puff that was left in my relatively-normal nipples bothered me. I visited plastic surgeons to get consultations and a variety of opinions about how to fix my issue, and I almost always got the same answer: they could operate on me, but it probably wouldn't make the issue better. Lista noted this as a lasting effect on men whose gynecomastia has improved over the years.
"Sometimes people complain about a big nipple rather than a puffy nipple, meaning the size—the diameter of the areola—is big, and that's really hard to fix without a lot of scarring. It might just be something that you have to live with it."
Nowadays, my nipples aren't as bad and I'm generally comfortable with what puff is left. Even so, I still catch myself flicking my nipples once on each side as I enter locker rooms or public pools, and the anxiety that used to accompany taking off my shirt still lingers like a hum at the back of my head.
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