Surgeon's experience level question

[pike09]

Hello, I'm a new member here but have referred to this site for some time.  My question arose when I started looking for a doctor for the procedure.  I'm 26, very lean and have always been in tip top shape.  I made an appointment and had a consultation where the board certified surgeon perscribed kenalog injections into the glandular tissue.  I went through with it and suffered a year with muscle atrophy and NO changes to the target glands.  There are a few plastic surgeons within a short drive but they have not had much, if any experience with the removal of the male glandular tissue.  My case is 100% glandular with no fat deposits.  Should I be looking for a doctor that has conducted this procedure and has great experience?  Is it that critical or should a board certified surgeon be able to handle the procedure?  Thank you in advance.

[DrBermant]

Hello, I'm a new member here but have referred to this site for some time.  My question arose when I started looking for a doctor for the procedure.  I'm 26, very lean and have always been in tip top shape.  I made an appointment and had a consultation where the board certified surgeon perscribed kenalog injections into the glandular tissue.  I went through with it and suffered a year with muscle atrophy and NO changes to the target glands.  There are a few plastic surgeons within a short drive but they have not had much, if any experience with the removal of the male glandular tissue.  My case is 100% glandular with no fat deposits.  Should I be looking for a doctor that has conducted this procedure and has great experience?  Is it that critical or should a board certified surgeon be able to handle the procedure?  Thank you in advance.

Actually there is no such thing as 100% gland only gynecomastia.  Even extremely low body fat marathon runners and Bodybuilders with Gynecomastia will have a fat contribution to the contour as you can see in this Anatomy of Puffy Nipple Gynecomastia.

Not all surgeons have the same skills. Here is a series of posts I put here about How to pick a gynecomastia surgeon:

http://www.gynecomastia.org/smf/index.php?topic=16474.0

This is surgical sculpture.  It is like saying that any painter should be able to do a painting.  Yea right, unless you are looking for a Da Vinci quality effort! A good sculptor should be able to demonstrate the quality of his / her sculpting skills.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[pike09]

That does help and gives me more insight on what to look for.  It looks like I may be planning a trip out of here.  I understand that there will be some fat associated with the glands but it is minimal; also having less than 6% body fat.  I've never considered the use of steroids, thought about smoking anything for that matter so I'm tracing it to hormonal imbalances.  For some reason the past two months have been a bit painfull as the glands are growing rapidly and are very tender (grown by 1/3 within two months).  I will continue my search for the right surgeon for I do not see him anywhere in Utah.

[DrBermant]

That does help and gives me more insight on what to look for.  It looks like I may be planning a trip out of here.  I understand that there will be some fat associated with the glands but it is minimal; also having less than 6% body fat.  I've never considered the use of steroids, thought about smoking anything for that matter so I'm tracing it to hormonal imbalances.  For some reason the past two months have been a bit painfull as the glands are growing rapidly and are very tender (grown by 1/3 within two months).  I will continue my search for the right surgeon for I do not see him anywhere in Utah.

Growth and pain are some common Symptoms of Gynecomastia that are better stabilized before surgery.  Although I target gland first, gynecomastia surgery does not stop further breast growth. Working with an experienced Endocrinologist can help find the Cause of Gynecomastia.  Unfortunately, endocrinologists like surgeons each have their skills and areas of expertise.  This week I was just working with the Castle Connolly Best Doctors in America people to try to get them to help with such issues for Endocrinology.  At present, there are no Endocrinologists in that guide who list gynecomastia as an area of expertise.  This is an area of medicine that can take a meticulous Sherlock Holmes like personality to focus on a vague and sometimes hard to define issue.

Stabilizing the problem before considering surgery is the best way to minimize the chance of recurrence.  Recurrence for my patients is quite uncommon, but I do see quite a few patients with recurrence and regrowth after other surgeons' operations when such issues are not stabilized first.

Perhaps that is why we see so many patients from Utah who prefer my techniques.  To minimize travel, patients often start with our Preliminary Remote Discussion.  Jane is my office manager and can explain the process.  She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction