That’s the question Mel Bircoll, the chief of plastic surgery at Beverly Hills Medical Center, was repeatedly asked in the 1980s by several of his male patients. It would eventually sow the desire within him to innovate vanity pectoral implants for men.
Granted, methods for inserting cosmetic pectoral substitutes into men’s chest regions were initially developed in the 1970s with the altruistic intention of enabling the sufferers of Poland’s syndrome — a genetic condition in which one side of the chest is severely hindered in its development — to become less self-conscious. But in 1988, Bircoll successfully pioneered a surgical procedure with the intention of inflating the chests of men with otherwise normal and reasonable pectoral development.
Bircoll’s original implant — measuring 7 inches long, 3 inches wide and 1 inch thick — was inserted into the chest regions of patients through 1.5-inch incisions made in each armpit. However, it wasn’t until September 1990 that US Magazine widely reported for the very first time that pectoral implants had become an option available to men within the general public for $6,500 a pop. In that report, Beverly Hills plastic surgeon Brian Novack ambitiously projected that pectoral implants would one day become every bit as popular with men as breast augmentations had become with women.
In terms of the landscape of the plastic surgery industry, pec implants found themselves figuratively inserted into an environment in which the number of male plastic surgeries were on a steep incline. Newsweek reported in November 1990 that men were accounting for nearly 20 percent of all plastic surgery patients, up from 5 percent at the beginning of the 1980s — a number that plastic surgeons hoped pec implants would bolster even further.
At the same time, such optimism was tempered by concerns over the safety and efficacy of the pec implantation procedure. “I won’t perform pectoral implants on men until the procedure has proven itself to be safe,” Norman M. Cole, president of the American Society of Plastic and Reproductive Surgeons, told the Newsweek reporter. He then posed a semi-rhetorical question: “Will they stand up to a rigorous game of touch football?”
Maybe for this reason, the rollout of pectoral implants was relatively slow. Bircoll himself had only performed about 50 such surgeries in the prior 18 months before he explained his procedure to the Los Angeles Daily News in 1991. “Men and women have the same vanities,” Bircoll opined, likening the procedure to the breast-enhancement surgeries women had been subjecting themselves to for decades at that point. “We’ve been doing this operation for 40 years, so there’s no basic reason why we should look at this very differently. We’ve had a great deal of experience. There are several million people who have silicon implanted into their body.”
A year later, the surgery had gained the nickname of “The Arnie,” after bodybuilding/film icon Arnold Schwarzenegger, and it had migrated to other areas of the country. But even in an image-conscious hot spot like South Florida, The Arnie didn’t exactly set the plastic surgery world on fire. “I haven’t had a lot of requests for it,” Dr. Lawrence Korpeck revealed to the South Florida Sun Sentinel.
Other Florida-based plastic surgeons flat-out refused to perform the procedure. “I don’t think it should be done,” said Gary Rosenberg, president of the Palm Beach County Society of Plastic and Reconstructive Surgeons. “With exercise and proper diet, men can augment their chests themselves. A pectoral implant is a shortcut, and I think it’s an unnecessary surgery with unnecessary risk.”
The prevalence of plastic surgery amongst men did increase by 63 percent in the early part of the 1990s, but pectoral implants lagged behind other forms of male cosmetic surgery in popularity and prevalence. A snapshot of the industry provided by the American Society of Cosmetic Surgery and reported by the New York Times indicates that only 32 pectoral implants were performed on men during all of 1994, compared to 190 calf implants, 37,343 liposuction procedures and more than 197,000 hair restorations. Far more telling were the 5,654 male breast reductions performed during that year. Apparently, men on the whole were far more preoccupied with the removal of fatty tissue from their chest regions than they were with artificially enhancing the muscles of the same general area.
For the remainder of the 1990s, the amateur bodybuilder emerged as the archetypal patient for pectoral implants. They were men who routinely worked out, but who were dissatisfied with the overall development of their chest muscles. However, even they abandoned the surgery in late 1999 when Miami Springs bodybuilder Alexander Baez described for the South Florida Sun Sentinel how he allowed unlicensed medical professional Reinaldo Silvestre to perform a pectoral implantation surgery on him. When it was all said and done, Silvestre left Baez with a mangled chest, and a pair of female breast implants where the pectoral implants should have been.
Ironically, it appears to have been the tech boom that brought it back to some degree of prominence. In a fall 2000 edition of Business 2.0 Magazine, C. Ashton Durham of Atlanta explained the motivations that led him to seek out a “male boob job.” “Pectoral implants have given me a level of confidence I’ve never had,” he boasted. “All the men in the internet startups and the models in the magazines have great physiques, and that’s the look I wanted.” (“Many dot-com companies are so youth-dominated that a lot of men don’t feel as confident as they used to,” plastic surgeon Darrick Antell added.)
That said, the total number of pectoral implant surgeries remained relatively unimpressive next to most cosmetic procedures. And by 2004, USA Today downgraded pectoral implant surgery once again to a “fringe procedure” that was only performed 206 times in the prior year. Even when the American Society of Plastic Surgeons reported a 43 percent increase in these procedures between 2011 and 2012, the absolute number still topped out at 317 — a minuscule sum compared to the nearly 20,000 male breast-reduction surgeries that year.
That same year, there was a major scandal involving France-based implant developer Poly Implant Prothese. As reported by Reuters, 300,000 women had received implants composed of cheap, industrial-grade silicone during the preceding decade. French newspaper Le Parisien added to this reporting by stating that the inferior silicone had made its ways into implants for testicles, buttocks and pectorals, too.
Ever since, muscle enhancement surgeries for men have remained so rare in comparison to liposuction and other procedures that many plastic surgeons don’t bother wasting the ink, text or advertising space to promote them. The rationale behind this prosthetic aversion is perhaps best summed up by plastic surgeon Greg Waslen, who told the Calgary Herald in 2014 that he didn’t know of a single plastic surgeon in the Canadian city who was willing to perform the surgery despite the media frenzy the thought of the procedure had once generated. Or as he bluntly put it, “Few men are interested in a purely cosmetic procedure that doesn’t actually add muscle mass or increase strength.”