If you don’t have a strong stomach, you should probably steer clear of the wildly popular Dr. Pimple Popper reality series on TLC. The show follows the operation exploits of dermatologist Sandra Lee, who has created a massive brand around extracting all sorts of gross growths from her patients. In a recent episode of the show, she contended with a guy suffering from a testicle-shaped growth on his neck that was making it impossible to sleep.

The man’s name is John, and he’s been dealing with the growth for two whole decades. Dr. Pimple Popper doesn’t make him feel bad about the lipoma, which is the size of a grapefruit and dangles directly down the front of his neck like a ballsack. The massive lump makes it difficult for John to breathe when he’s lying on his back, as its weight depresses and constricts his airway.

“I went to a physician that wanted to perform surgery on it, he told me they could cut the wrong vessel and I could be possibly be paralyzed on one side of my face,” he said. “That kind of scared me away, so I just let it go.”

Thankfully, Dr. Lee gave him more faith in her abilities, and he went under the knife for the procedure. After consulting with a radiologist, Dr. Lee learned that the growth was under the platysma muscle, an area she typically does not operate on. But, in John’s case, she determined that she could handle it and after a grueling operation managed to completely remove it.