Surgery with Dr. Bermant (3/14/2009)

[mrpower33]

Hey guys, I've also been trolling for a long time now and just had surgery with Dr. Bermant on Saturday.  Here's my experience:

I've had puffy nipples since about 10-11 and now I'm 31, so it's been quite a long time.  They were pretty puffy in high school, but shrank a bit in college.  I sorta forgot about them for several years, but it's always been in the back of my head and lately, as I've been trying to get back in shape I've noticed that it is very difficult to get rid of the fat deposits in my chest and it would just look so much better if I had flat nipples.  So to start with, I tried the AIFM, Yohimburn, Cabaser and Exemestane route, spent around $500 on all that stuff.  Personally, I believe that it could have worked if I were still a teenager and maybe I would even be a little taller from all the literature I read (and I read a lot of stuff).  But I think after a few years, the glands undergo fibrosis and surgery is pretty much the only option (although I know there are lots of people out there who believe otherwise).  Suffice to say, I didn't get to the surgery option easily, although once I started reading the posts on this site I pretty much couldn't get it out of my mind.  I think that a lot of us here probably suffer from some mild form of neurosis, most likely caused by our own physiological predisposition coupled with gynecomastia growing up.  The truth is, so many men out there have it and don't give it a second thought.  Anyway, just my own armchair diagnosis of myself. 

It's weird because I would never have thought of myself as someone who would get plastic surgery, I know others have made similar comments.  In fact, right after the surgery, what I was really thinking was "what the f have I done!"  But the truth is, once I decided that I wanted this there really was no turning back.  As for my experience with Dr. Bermant, I must say, the guy has definitely got a system down.  From the looks of things, this is his specialty and he has an almost scripted process and he's very methodical about it.  I'm from California, which is a pain because there are no direct flights into Richmond.  So I took Thursday to travel with a Friday morning pre-op appointment.  The appointment was nearly identical to all the other experiences people have posted about Bermant.  I had an initial exam with the doctor, he made some measurements, took some pictures, made the markings, I was fitted for the stage 1 and stage 2 and then I was out of there.  Jane was super nice like everyone has said.  The next day, I went in for surgery, spoke with Jim the anesthetist like everyone else (he's a funny guy and really puts you at ease).  Next thing I know, it's all done.  I saw the glands they took out and was pretty surprised at how small they were, they were about the size of dice cubes.  They got me a nurse, Kim, to drive me to get some food and back to my hotel to rest for 6 hours.  She drove me back to my car around 9 and I drove myself back and rested the rest of the night and on Sunday.  Like others have said, there wasn't very much pain, more like discomfort after a really hard work-out and all I took was Tylenol.  I bought both regular and PM, the PM really helped me sleep.  Monday was my post-op appointment and I got to take off the vest and see what it looked like.  There was some bruising that freaked me out.  Bermant seemed to think there was a great deal of contour change, but I honestly couldn't really tell.  The truth is I really only care about the nipples and those are still covered by gauze and will be until next Wednesday so I will need to reserve judgment until then.  He also took about 100 cc's of fat from each chest.  I headed straight to the airport after that and got home last night.  Pretty exhausting trip.

I will have to say that for a surgical procedure, it could not have gone any more smoothly in my opinion.  I don't think I would have tried to do this if Bermant did not have such a smoothly run operation, particularly for people from out of town, I think he really caters to them (no drains, private nurse, remote dressing removal, etc.).  On Monday, there were three other people in the office waiting to see him, so it looks like he just does these all day long.  So it's Tuesday right now and I actually feel pretty good, but I have to agree with others who wrote that the surgery is the easy part.  Even though I was pretty freaked out, the reality is it's over before you even know it.  Now I have to stress about how it's going to look when I take the gauze off, that's even worse than the anticipation of getting the surgery!  I have to say that for people with puffy nipples and other mild cases in general, it's a difficult decision and you need to pick your surgeon really well if you decide to do it.  If this comes out poorly, I will be pretty upset because it wasn't that big a deal to begin with.  So in other words, it really needs to come out well to justify the time, pain and expense.  Just food for thought for some of you with borderline cases.  My total cost was around $6500 (not including travel), which is pretty much in line with what I read from others.  I'll keep you guys updated on my progress and post before after pictures when I get the gauze off next week. 

[gettingthere]

Coffee, going under was the easiest part of the whole deal. The anesthetist talked to me while I waited in pre-op. Funny, how things pop into your head, but the only question I had for her was, "Do I have to worry about loosing control of my bladder " Absolutely not she said. 

The nurse had already put an IV port in my arm, so when it was time for surgery, I walked into the operating room where I was greeted by four nurses... all of them very friendly. One of them asked me to repeat out loud the surgery I was about to have. Then I was asked to get my self on the operating room table and make my self comfortable. I had time enough for about one or two sentence of small talk before I went under. They didn't have a mask on my yet, so while I was chatting it up someone was shooting the initial dose of meds in my IV port. Probably less than 5 seconds later, I was out. No more than one or two minutes passed from the time I was on the table til the time I was asleep. There was absolutely no sensation or awareness whatsoever.

2 hours later, I was waking up as if coming out of a pleasant sleep. Some folks don't react to well to anesthesia drugs and get sick to the stomach when coming back up. For me it was, like I said, it was waking up from a pleasant sleep. It took about an hour to come around again to a point where I could be driven home. Piece of cake. The bumps in the road were the only hard part. Fortunately, the anesthesia can linger for up to a day later, so that really helped in the transition from surgery to home.

Like everyone says, the hardest part is afterwards. Not so much with pain but dealing with the emotions. I'm a man of little patience and for the three days that I gave myself to get back on my feet and back to work, this site has a godsend. Patience is really the key to recovery. I figure I dealt with this all my life, the least I can do is give myself week, even months, to "heal and deal" properly.

Do your homework, set your goals and, if it's right for you, go for it. The rest, you'll sort out the best you can.

Good luck; hope this helps.
Getting There

[mrpower33]

Hey Coffee, I know exactly what you are going through, the anticipation is really the worst part of it, I felt like everything was on hold.  If I were you, I would go work out hard for the next two weeks and get in the best shape you can because you are not going to be able to work out for several weeks after the operation.  I've never had any type of surgery either, so I was pretty nervous.  But it really was the easiest part.  The day of the op, I was told to undress completely and put on one of those hospital gowns that open in the back.  The anesthesiologist came to see me in the exam room and explained the whole process.  He stuck an IV in my arm, which was probably the most painful part of the whole thing, but really just like someone sticking a pen into your arm for a few seconds and then you don't feel it after that.  What's awesome if that the first thing they give you from the IV is a drug similar to Valium, so after a few minutes, you're feeling pretty relaxed.  Then I was walked over the OR, strapped down on the table, and after a minutes of small talk I was out cold.  I don't even remember falling asleep, the next thing you know, it's over.  I didn't feel sick or tired, just a little groggy, but after a few minutes, I was pretty alert.  It helped a lot that everyone was super nice and did everything they could to keep me relaxed.  Again, there wasn't much pain, just a sore feeling throughout the chest area.  If you read other posts about Bermant and his team, you get the same story, so that's pretty important.  I did a lot of research before hand and the weird thing is that it came out almost exactly as other posts I have read.  I don't know anything about your surgeon, but hopefully he/she has a pretty good operation going.  Honestly, just try your best not to think about it, it really is a simple, out-patient procedure.  Just keep telling yourself that.  I mean, think about it, there are people who have to get brain surgery or heart surgery.  Now THAT'S something to stress about.  Just try to keep things in perspective.   

[zane949]

Hey mr power any update? Pre/post pics am in a similair situation as you are would like your input.

[mrpower33]

Yeah, I will post soon, I get the cellophane bandages off tomorrow morning, it will be the first time I get finally see my nips since the operation.  Wish me luck!

[mrpower33]

Hey guys, just a quick update, I got the dressings off today (11 days post-op) and everything looks pretty good.  My left side is still a bit swollen and tender, but the right side feels great.  I still have some bruising, mostly on the left side.  It would have been awesome if the left side healed as quickly as the right, but what are you gonna do.  As far as the nipples go, the puffiness is definitely gone and I'm pretty amazed at how flat they look.  I just hope they stay that way.  I have steristrips all over the nipples right now, so they are still difficult to see.   I'll post pictures at the 3 week mark when I get to take them off.  That should be pretty good indicator of the final result.  Hopefully I will be pretty far along the healing process by then too so I can give my final assessment on Bermant to you guys, but so far so good. 

[mizuno]

Glad to hear it. Please post the pics when you get a chance.
Also, how much fat was taken out ? Did you do the remote consultation ?

[zane949]

Hey dude any updates or pics how is everything?

[mrpower33]

Hey guys, as promised, I'm going to post some pre-op and post-op below.  I am exactly 5 weeks post-op and I moved on to the Stage 2 Vest about two days ago.  Here is also a breakdown of total costs for those of you who want to budget for a surgery that requires travel:

Remote Consultation: $200
Surgery: $6270
Stage 1 Vest: $99
Stage 2  Vest: $99
Pathology for Tissue: $174
Nurse (6 hours): $150
Prescription pain pills: $13.68
Hotel (4 nights @Holiday Inn Express): $370.94
Airfare: $240.40
Car Rental (5 days): $117.08
Vitalzym Supplement (270 pills): $83
Maderma Scar Care Cream: $25
Arnica Bruise Cream: $10
Total: $7852.10

Yeah, it's a lot of money, but I have to say that I am pretty happy with the results so far.  Dr. Bermant really delivers.  As you can see, my case is pretty subtle, so I tried to post the pictures that show the problem the best.  You can see that the left side is still a little bit swollen and it's also still a bit tender, but it is getting better week by week.  The puffiness along the scar is also still there, but subsiding.  When it heals up, I'm pretty sure the incision will be difficult to see if you can see it at all.  I was thinking about another post I read a few days ago about whether the operation is a "cake-walk".  Well, that's not really the best phrase to use I think.  I had a pretty minor case, I have a lot of money saved up and I'm a single guy in good health, but I have to say that the whole thing has been pretty disruptive on my life.  I mean, I am a moderately active individual in my early 30s and for the past 5 weeks I have had to stop all exercise and really cut down on going out with people.  Only starting this week have I begun to really feel like my body is getting back to normal.  So to be safe, I am going to wait another full week before I start working out again.  I am DYING to hit the weights again, I feel like my muscles have totally atrophied and since I had a little bit of lipo (100cc taken out of one side and 75cc from the other), my chest looks a lot smaller.  But that's a good thing, because I'm pretty sure I would never have been able to get rid of that chest fat any other way.  Psychologically, it has also been difficult because I haven't told anyone about it (except for you guys of course).  I have roommates that I am pretty close with, so making excuses about not going out or being paranoid about getting a titty twister or getting punched in the chest or getting put in a head-lock, locking myself in my room, worried about someone noticing the vest, wearing jackest all the time and so on, it's been really exhausting mentally!  The Stage 2 Vest has been AWESOME, it really helps in feeling like you're getting back to normal again.

The operation itself, however, went EXTREMELY WELL, it is a rare in my experience for something to go exactly as planned, especially something like traveling cross-country to get a surgical procedure and if you haven't figured it out by now, I am a planner about everything.  But I have to give Dr. Bermant credit for running such an excellent and professional operation.  The experiences you have read on this board about his procedure was exactly how it went for me and it is very comforting to get a preview of something and then to experience it exactly that way.  He definitely is an expert at this and for anyone who is concerned about scarring, cratering or getting anything other than a near-perfect result, you have to really consider this guy.  I am from California and I had to take a connecting flight in NJ, which is one of the most awful travel experiences I have had to endure (delays like no other), it was also raining when I arrived in Virginia, but I wouldn't have had it any other way.  So except for international folks, if you have the money, you don't have an excuse not to consider going with Bermant.  Bottom line: you get what you pay for!  You can always make more money but you only get this one body to work with.  

The healing process has been slower than I expected from reading this forum, but maybe because some of you guys are in your 20s, I'm sure that age makes a big difference, so if you're going to do this, you should decide sooner than later (this does NOT apply to teens who have minor cases, you should really wait until you are over 18 and sure it won't go away with diet and exercise before resorting to surgery).  I was able to travel within 48 hours of the operation (Saturday surgery, Monday afternoon flight).  I could have gone to work on Tuesday, but I took the day off to rest and went in on Wednesday.  Pretty sore the first week, but still able to do most things normally.  My right chest was pretty much fine after two weeks, but like I said, my left chest has been much slower to heal (it also had more bruising and swelling).  It really wasn't until the start of the 5 week that my left chest started to feel normal.  I bought a bottle of Vitalzym on the advice of Mangina.  I can't tell whether it has helped, but I'm going to finish off the bottle since I've already bought it.  I have also been taking Vitamin C.  The Arnica gel really helped with the bruising, just to give you guys a tip.  It is cheap and you can get it at any drugstore.  Also, the Maderma scar cream is excellent, I highly recommend that as well.

Another tidbit on healing, I was a little freaked out because after I took off my dressings on the 11th day post-op, my right nipple looked really black and had no feeling.  I was worried about skin necrosis, but if you read some other posts on this forum, it's just dried blood and a layer of dead skin.  After a week of showering, it started to looked normal again.  I think the chances of actually losing your nipple in an operation like this is something like 1%, so you probably don't need to freak out about it.  

Generally speaking, I am pleased with the result thus far and I don't regret getting the operation despite the cost and the trouble.  It's just nice to get it over with and hopefully not have to think about it again.  I really like t-shirts and I bought a few online the other day as the weather here is getting warmer and it will be nice to be able to wear those ultra-soft/thin t-shirts and not have to thing twice about it.  Seems like a simple pleasure, and I know some of you have it much worse both with your gynecomastia, health or with your finances.  I guess the only unsolicited advice I can give you is that there is value in overcoming an obstacle in your life and knowing that once you've overcome it, you never have to deal with it again.  As stupid and minor as this thing was for me in the whole grand scheme of things, it feels nice to know it's been taken care of and it does encourage me to take on other challenges in my life (and there are certainly many more of those).  So for those of you who still struggle with this and geez, I think about some of you guys and my heart really goes out to you, especially the hemophelia guy, you gotta know that the bigger the challenge the bigger the payoff.  So just keep working out, keep saving your money, keep doing your research and plan this whole thing out as well as you possibly can.  And you know, you'll be fine.

Hope that wasn't too melodramatic.  Feel free to ask questions.

[mrpower33]

Pre-op photos:

[mrpower33]

More Pre-op photos:

[mrpower33]

5 weeks post-op photos:

[mrpower33]

More 5-weeks post-op photos:

[mizuno]

Sweet Results !!
Did he remove alot of gland ? You were in pretty good shape before going in.
But, it does look noticeably better.
Thanks.

[mrpower33]

Here is a photo of the glands.