A procedure designed to take care of the excess fatty bulges between the collarbones to the pubic area is the Torsoplasty.

But hold on, sports fans! The Torsoplasty is for men at — or near — their optimum weight. Rough rule of thumb is: if you can pinch and hold a fatty area anywhere on your chest or lower abdomen, we can remove it while you are undergoing gynecomastia plastic surgery.

But if you have a protruding beer belly, a Torsoplasty can’t help there – the procedure is not a treatment for obesity.  That fat sits deep within your body, surrounding your internal organs. The fat we remove is above the muscle layer and just under the skin.

The only known treatment for that deep-down fat is the one you probably don’t want to hear: eat less, work out more.

Torsoplasty is something to consider if you are going to have gynecomastia surgery to remove your man boobs. The cost of surgery is much less by combining the two procedures in one surgical session.

Torsoplasty is often appropriate because even a very fit and active guy can be subjected to Mother Nature’s whims and have deposits of fat on the chest, stomach and side that just will not respond to stricter dieting and the most active workouts.

How capricious is Mother Nature? When a male gains weight, fat usually appears first on his chest, stomach and love handles. After that, the weight appears on the rest of his body.

And as he loses weight, the last places to become thinner are:

• The love handles
• Stomach
• Chest.

You can get an idea of the typical patients by looking at some Torsoplasty and gynecomastia surgery before and after pictures. (Pan down to picture #68)

After a Torsoplasty, the patient wears a one-piece body suit that fastens with eyes and hooks as well as a zipper.

It all helps:

• The body to heal
• Skin to tighten
• Lessen swelling
• Reduce pain

It dawned on me later that Dr. Adams filmed me and one of my teen patients back in October of 2007.

I mention it because it’s one of the few filmed pieces I’ve seen that actually shows the breast, or glandular, tissue seen in gynecomastia.

The video follows a 15-year-old who loves sports but at 12 or 13 developed a serious case of gynecomastia, with very pronounced, female-like breasts that were hard to hide, even under heavy T-shirts.

Most days, he wore a compression garment as a T-shirt to conceal his pubescent-like breasts.

The problem? Sports were out of the question. As was taking off his shirt in public.

One of the charms of Plastic Surgery: Before and After was that, unlike most television shows about plastic surgery, Dr. Adams intended his programs  for adults and showed unfiltered, close-up segments of actual plastic surgery.

But most other programs blur or blank out surgical scenes as if they were X-rated sexual content.

The concept was not to make viewers lose their lunch by filming endless gore, but to show just enough to put across a teaching moment.

When Dr. Adams and crew filmed me operating on the teen, they showed how much work it was to liposuction out the fatty tissue from his breasts.

When it came to removing the actual glandular breast tissue, they zoomed in close and captured the look of the bone-white breast tissue as it was excised from the lad’s chest.

Glandular tissue is far too thick for liposuction.

The rest of the operation went well, the youngster healed and returned home where he could once again indulge in all the sports he wanted while taking no care at all about hiding his chest.

In fact, I think Dr. Adams’ film crew gave other gynecomastia sufferers a moment of supreme elation for the many youngsters who live in that world.

They filmed my patient gladly and willingly doffing his shirt to play basketball.

Why is that noteworthy, you ask?

For gynecomastia-stricken teens, hearing the command “Shirt and skins!” from a phys ed teacher is a moment of sheer terror!

“Skins” must peel off their shirts and then jump up and down, playing basketball. And that puts all eyes on their jiggling breasts.

Here’s the video: