bermant, where did you learn your technique?

[gynebob3]

did you develop the "remove-gland-first followed by fatflap"-technique yourself, or did you learn it from another doctor?
have you ever taught your technique to someone else?

your techique seems like the best way to tackle this issue to get great results when flexing/animation, but it puzzles me that I havent seen any other doctors that does it the same way

[DrBermant]

did you develop the "remove-gland-first followed by fatflap"-technique yourself, or did you learn it from another doctor?
have you ever taught your technique to someone else?

your techique seems like the best way to tackle this issue to get great results when flexing/animation, but it puzzles me that I havent seen any other doctors that does it the same way

Thank you for your kind words.

I evolved my Dynamic Technique for Gynecomastia surgery myself after an analysis of the literature, establishing a more critical evaluation documentation, and seeing unhappy patients from other doctors complaining of contour issues that just were not showing up with a few photographic views. It involves so much more than what some doctors who have put it down here in the forum of adopting to what I find in the operating room. It starts out with establishing a stable problem to sculpt, targeting gland first so that the firm component no longer can offer a differential for tissue compression when flexing the muscles, and using an assortment of surgical sculpture tools to perform my contouring.

Yet all surgery advancements stands on the shoulders of teachers. Some of the teaching was by seeing disasters as in watching a General Surgeon in medical school perform gynecomastia surgery without tools such as liposuction or flaps. My paperwork documentation was inspired by Dr. Tebbetts rhinoplasty teaching, the photographic components of more critically understanding the problem started with Dr. Desomond Kernahan who took me under his wings while I was in medical school. But that was in still 35mm photos that missed the issue of animation. Dr. William Shaw taught me the value of using living vascularized tissue for my sculpture when possible, but that was for microvasculized free flaps. Dr. Allen VanBeek challenged me to use the Internet for Plastic Surgery Education for both the public and our fellow Plastic Surgeons. The other surgeons I learned from by seeing their unhappy patients are too many to easily number.

Yes, I have published, lectured, and developed my internet based education tools that I have received peer praise from that many surgeons have told me they have used to learn from. I took components of my methodology to develop my Tumescent Tummy Tuck which I later learned that several surgeons had also come up with on their own.

Good techniques, when analyzed with more critical documentation tools, have a way of taking over when the public asks to get similar results. They tend to be evolutionary and not static as further refinement permits tissues to look good with animation and when people more critically look at the bruising, swelling, and discomfort paths each patient needs to take. I just operated on a patient who had first been seen in my office over 8 years before. The change in my documentation system was fun to see how much has changed with a system designed to keep challenging results and methods.

Hope this helps,

Michael Bermant, M.D.