Vest or Binder?

[Plarkin]

I notice that the two top docs on here (Jacobs and Bermant) have different post-surgery garments they recommend. Bermant seems to go with a compression vest, various stages, for a few weeks. Jacobs opts for a binder, for, I think, a few days, and then tight Under Armour tee-shirts. The later, obviously, seems easier. Are the results the same? Why the difference? I know and respect that the two docs won't comment on each others procedures. But still I'm wondering.

[Dr. Elliot Jacobs]

I prefer a binder because it has an infinite amount of variation possibilities so as to provide the best tight compression after surgery without obviously compromising your breathing.  I admit is more cumbersome than a vest -- but overall it provides much greater compression.  A vest is more comfortable, but only has one or two "gatches" so that you are limited as to how tight you can make it.

Most of my patients get used to a binder very quickly and in fact feel that it provides them with a real sense of tightness and security after surgery.

Dr Jacobs

[DrBermant]

I notice that the two top docs on here (Jacobs and Bermant) have different post-surgery garments they recommend. Bermant seems to go with a compression vest, various stages, for a few weeks. Jacobs opts for a binder, for, I think, a few days, and then tight Under Armour tee-shirts. The later, obviously, seems easier. Are the results the same? Why the difference? I know and respect that the two docs won't comment on each others procedures. But still I'm wondering.

I do not like binders after surgery.  They tend to ride up, change position, and be uncomfortable. Their adjustability can be dangerous permitting a patient to put too much or not enough pressure on the healing tissues.  That is why I prefer the After Gynecomastia Surgery Compression Garments I helped that company evolve.  Each patient in my office is fitted before surgery with both a First Stage After Surgery Garment and a Second Stage After Male Chest Surgery Vest before their operation.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia

[Plarkin]

Thanks, Docs.

[Grandpa Bambu]

I was given an Ace wrap at the hospital. It was a PITA! It would not stay in position and required an extra pair of hands to put it on.

I purchased the Dale Medical 'Ab Binder' as a replacement to the Ace wrap. A world of difference! It's easy to put on and take of. It has infinite tension settings (Velcro) as Dr. Jacobs mentioned so that you will not loose tension after prolonged usage/washings. I found that the binder did not move out of position at all as the Ace wrap did.

As for 'amount' of compression, would common sense not dictate for the user to put it on 'snug'? Not 'overly tight' and not 'loose'. We all know how to apply a bandage right? Take for example a laceration to the finger... I don't think anyone would put a bandage on so tight that the finger tip would turn purple. At the same time, would anyone put it on so loose that it falls off? It's all common sense IMO!!!

GB...

[Dr. Elliot Jacobs]

GB

Your experience mirrors my own.  When a binder is properly applied, it need not twist/distort/roll up and it can apply the needed firm pressure that helps keep down swelling and bruising.  It is one of my best aids in helping my patients heal quickly from surgery -- and more often than not, it negates the need for me to use a drain.  In fact, I use a drain in only 1 or 2 cases a year.

Dr Jacobs

[MyName]

I was given a binder post surgery and it was a pain in the a$$. I had to "safety pin" it to my t-shirt and would still slip down throughout the day and I would have to re-adjust it.
My advice is go with the binder!

[MyName]

Sorry! I meant vest!

[Grandpa Bambu]

Sorry! I meant vest!

So.... you are recommending a 'vest' or a 'binder'? I'm assuming you mean the vest...

GB

[DrBermant]

I was given an Ace wrap at the hospital. It was a PITA! It would not stay in position and required an extra pair of hands to put it on.

I purchased the Dale Medical 'Ab Binder' as a replacement to the Ace wrap. A world of difference! It's easy to put on and take of. It has infinite tension settings (Velcro) as Dr. Jacobs mentioned so that you will not loose tension after prolonged usage/washings. I found that the binder did not move out of position at all as the Ace wrap did.

As for 'amount' of compression, would common sense not dictate for the user to put it on 'snug'? Not 'overly tight' and not 'loose'. We all know how to apply a bandage right? Take for example a laceration to the finger... I don't think anyone would put a bandage on so tight that the finger tip would turn purple. At the same time, would anyone put it on so loose that it falls off? It's all common sense IMO!!!

GB...

I agree, an Ace wrap is an even worse option since it requires the patient to have someone else change it.

Each surgeon has his / her preferences.

Too little pressure, and there is swelling and discomfort.  Too much pressure and injured tissues may not get enough blood supply possibly causing loss of tissue. 

Common sense does not work well on tissues that have impaired sensation, are injured, or cannot be seen.  For patient safety, I prefer to calibrate the pressure in a repeatable fashion.  I can do that with my compression garment.  A Dale binder can be marked with a pen, but still does not produce a consistent enough quantity of pressure.

Not all doctors will show early swelling and bruising after gynecomastia surgery.  Less swelling and bruising can translate into better comfort after male breast reduction.  For me my patients' safety comes first.  By standardizing the pressure on the healing tissues, I have removed a variable that has produced the results as shown.  I have seen many patients coming with scars from tissue lost after other doctors' ace wraps and binders. 

When taken care of, these garments can maintain their compression over an extended time.  I have had patients using Body Shaping Garments during weight loss or while getting a medical problem stabilized who have come back with a garment several years old that still had great pressure that we were able to use it for the second stage garment after their surgery!

Hope this helps,

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