CLEVELAND -- It's a day Zack Pichler has been dreaming about nearly a decade.
"It's just really exciting. There are no words. I can't wait," said Zack.
Zack was born Amanda, but at a young age the reflection he saw in the mirror didn't match how he saw himself.
"Living as a girl wasn't an option anymore. If I didn't start living as who I was, I was going to die. Through my own means. Maybe suicide," said Zack.
To hide his figure, Zack would bind his chest and layer his shirts.
But with the help of Dr. Daniel Medalie at MetroHealth Medical Center, Zack is about to undergo a double mastectomy.
"OK, OK. Let's do this," said Medalie.
Medalie is so well known around the world for sculpting a masculine chest, he operates on as many as eight patients a week.
Each one goes through extensive screening and counseling for a surgery that's irreversible.
"So far, knock on wood, I've never had a patient say 'You made a mistake and you shouldn't have done that operation,' " said Medalie.
Zack doesn't have any doubts about his surgery.
After a few hours in the OR and six weeks of recovery, Zack has the chest he's always wanted.
"Now, I can smile in the mirror and this is totally me! I look great," said Zack.
For Zach, shopping is now fun.
Instead of hiding his chest, he gets to wear shirts that show it off.
"It is a huge, huge weight gone," said Zack.
Zack is a psychology major at Cleveland State University.
He's planning to get a master's degree in counseling and stay right here in Cleveland so he can help others in the transgender community.