PS or General

[iviike000]

I talked to my mom today about surgery. She said that she wants me to get it done at a General surgeon instead of a PS. From reading the post I know that a PS is better. I told her the opinion of the board and she says that they don't know what they are talking about. She prolly thinks like this because she is a RN at a local hospital.

[rcbrown23]

Show her this site, and let her poke around a bit. She will see that their are many very well educated people on this site that can offer good, proven advice.

I agree with you that a PS is the way to go.

[jc71]

you need to school your mom on the difference between the two. do what you need to persuade your mom.  just don't go to a general surgeon.

[I-Hate-Gyno]

         Agreed. A ps does a hell of a lot more gyne surgerys than a gd. You don't want to be disappointed with a gd results.  :-/

         I-H-G

[Paa_Paw]

ivike000,

You do not give your age or your Mom's age.  These could be relevant.

Your age is important in that a lot or gynecomastia in puberty will resolve or go away on its own.  To be considering surgery, you should be well through puberty and your growth pretty well complete.

Your Mother's age is relevant in that her training may well have been completed before cosmetic surgery was recognized as a specialty and almost everything was done by General Surgeons.  

The person best able to influence your mother would likely be your regular family Doctor.  Tell him/her of your concerns and let them go to bat for you. Engaging your mother in an argument over this will probably not get you anywhere.  It is also possible that your mother knows a general Surgeon who she trusts and respects. perhaps this surgeon could also be your ally if your approach is diplomatic.

Surgery to remove/reduce male breasts has a high rate of patients who are less than thrilled with the results even under the best of conditions..  You can improve the possibility of a successful outcome by: 1) Being a Good surgical candidate.[Through puberty, growth complete, apropriate weight, hormones normal]  2) Using the services of the best Surgeon available.  3) Having a reasonable expectation of the surgical outcome.

Good Luck, Stay in touch.

[headheldhigh01]

tell her we've seen bad stories from people messed up because some general surgeon experienced or competent at other things has no clue about minimally invasive or disfiguring techniques.  ask her who's gonna know what they're talking about, -- her, or people it really matters to here?  

good at other things is different from good at gyne.  not worth screwing around, for money or convenience or anything.  

[DrBermant]

ivike000,

Surgery to remove/reduce male breasts has a high rate of patients who are less than thrilled with the results even under the best of conditions.

Sorry, I do not belive this is accurate.  The literature, doctors who have communicated to me, and my experience just do not agree.  My patients satisfaction rate that they express to me has been extraordinary.  I ask each patient how they like their new chests after surgery, and the response has been almost unanimous "I love my new chest."  The basic literature satisfaction rate is very high for gynecomastia surgery.  My best guess for my patients is somewhere about a 99% satisfaction rate from what has been told to me and my staff. The most common statement I hear from my patients when I ask them about their results has been "as good or better from what I expected."

The rate of satisfaction of posters in some internet forums can be much less.  Unhappy people tend to post looking for information, advice, and help. Some chose to help others and answer questions about their experiences.  Happy patients usually move on, the gynecomastia experiences for them, a thing of the past.  

ivike000,You can improve the possibility of a successful outcome by: 1) Being a Good surgical candidate.[Through puberty, growth complete, apropriate weight, hormones normal]  2) Using the services of the best Surgeon available.  3) Having a reasonable expectation of the surgical outcome.

These statements are what makes the difference in success.  

For the better surgeon, patient selection is a major factor.  If I operated on every patient that came to me, my patient satisfaction rate would not be as good.   Not all patients are reasonable candidates for surgery.  That is why we spend so much effort evaluating each patient before continuing with surgical options.

In other cases, surgeon skill is another issue. I have seen disasters from misadventures from around the world.  The worst have been from doctors who had no training, or were not board certified, or just had bad track records.  It can be a function of public responsibility to check on their doctors.  Why a patient would think that a Gynecologist would do a good job with Gynecomastia is beyond me when that doctor did not have any before / after images to show.  The same goes for problems from Emergency Room doctors who now want to call themselves "plastic surgeons." I have also heard dissatisfied patients reporting that their doctor said "boards are not important," and call themselves plastic surgeons anyway.  We doctors try to police ourselves by setting up organizations that require training, continuing education, and ethical behavior for membership.  Yet I see many patients who have had surgery by doctors who could not qualify for membership.

For some it is reasonable expectations.  Everything has limitations.  Medicine and Surgery are no exceptions.  Words expressed alone by themselves just are not enough to understand an individual's problem.  Evaluating a patients' concerns after surgery needs to include looking at the problem before surgery, what was done, the recovery, and what it looks like after surgery.  This process is best in person when tissues can be examined, felt, and watched moving.  The next best option is using standardized images that permit the contour to be evaluated from many different angles and to see how movement and tensing muscles can change the contour.  I have seen patients from other doctors coming to me to remove more tissue, that their breasts were still too big.  Yet there was nothing there, just skin adherent to muscle a cavity defect and depression.  Before considering any advice or complaints from someone that posts in a forum, careful evaluation of before and after images / movies can be very important.

Of course no surgeon can guarantee results.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture