My Story
I am 38 years old and have been uncomfortable taking off my shirt my entire life. I have struggled with my weight since I was a child. Over my lifetime I have gained weight and lost it several different times. Each time I lose weight I have hope that the moobs and love handles will go away. But the fact is, this never happens, even when my BMI has been in the normal category, I still do not feel comfortable taking off my shirt. For me this is fairly depressing and over time I tend to gain the weight back.
I have a 2 year old son. He loves to play in the water and pools as most kids do. On vacation this summer I was sitting by the side of the pool (as I always do) as other people played with him. He kept coming over to me wanting him to play with him. I said to myself that enough was enough and I had to do something about my insecurity. I decided to talk with my wife about my problem (very difficult) and we decided that if I can lose the weight again, we would spend the money for me to have surgery. So once again, I am going to the gym and watching what I eat. I am hoping to have surgery in November or December.
Deciding on a Doctor
I have been following this website for a while and doing research on the internet. Price is an issue for me, but more importantly I want to make sure that I get it right the first time. Therefore, I am willing to travel to wherever I need to in order to make this happen. As of right now, I think I have narrowed my choice down to two doctors, Dr. Delgado in SF or Dr. Bermant in VA.
After talking with the office personnel at both offices and checking out their respective websites, it appears that there are some distinct differences between the surgical techniques used by these two doctors. Based on feedback from this website it sounds like these guys are both reputable surgeons and are two of the very best at their craft. I am sure that I would be happy with the results of either doc but I have a question regarding their technique.
My understanding is that Dr. Delgado performs liposuction first and then removes the gland tissue after liposuction. He also uses general anesthesia and places drains that must be removed after surgery. He also likes the patient to stay around for a while after surgery for post op care.
My understanding with Dr. Bermant is that he (for the most part) uses sedation and removes the gland first. Then he uses liposuction to smooth everything out and obtain a flat chest. Dr. Bermant also allows you to go home after post op consultation.
I am looking to have gyno surgery and liposuction of the abdomen and flanks. I think that the price will be similar for both Doc's. I was wondering if anyone has any feedback or comments regarding their experience with these doctors and or the techniques that they use?
Thanks.
My sculpture has evolved over the years. Although a normal male chest will have a tiny amount of gland, it should not show when the areola muscles relax and in motion. A chest should look good beyond just a few still pictures. How it moves when playing sports, exercising, flexing are critical. It does not take much gland to distort the male chest. Residual gland and scar move like gland and scar, fat moves like fat.
I prefer my
Dynamic Technique where, what I find during surgery helps guide what needs to be done.
When gland is present, and it usually is, I prefer to start with and target the gland first. By concentrating on gland, I target the tissue that compresses the least and reserve the remaining fat as a potential tool for my reconstruction.
Liposuction is fine for fat. However, all forms of liposuction
- specially designed sharp cutting cannula
- ultrasonic
- vasor
- power assisted
all preferentially remove fat over gland. Check out the
Normal Anatomy of Gynecomastia. When fingers of fat are between fingers of gland, liposuction alone tends to suck out the fat condensing the gland behind making a mess.
When significant gland is present, I start at the edge of the chest skin areola interface. That is a great place to fool the eye about a scar. Typically for normal gynecomastia, I need only one small incision on each side often about 1.6 cm (a little over 1/2 inch). This is much better than needing 4 incisions. Direct access to the gland gives me direct access to controlling hemostasis (bleeding). This is a major factor in minimizing
Bruising and Swelling with my Gynecomastia Surgery and why I can post such
Early Healing After Gynecomastia Surgery Pictures. Less swelling and bruising often results in greater
Comfort After Gynecomastia Surgery.
Liposuction is but one of many tools of my artist's palette for surgical sculpture of the male chest and gynecomastia.
My
Fat Flaps can bring fat into a crater. A flap is tissue moved
with a blood supply. Adjacent fat transfered with a blood supply tends to survive, much better than a graft. When carefully done, fat flaps tend to look like normal fat, feel like normal fat, and move like normal fat. There are limitations to what fat flaps offer since fat still connected to its blood vessels will move only so far.
Try to go through the entire section about male chest sculpture on my site to learn what my techniques of surgery have to offer.
When liposuction is used first, a hole is often dug in the fat making a "flat" contour. But the firmer gland does not compress like the fat causing distortion. In addition, techniques that target the gland remotely need to come at the gland from the gland edges and often leave
a layer of gland under the areola that can look bad when the areola muscle relaxes and on animation.
Here are just a few of the many examples I have seen and treated:
Revision Gynecomastia After Failed Liposuction By Other SurgeonRevision Puffy Nipple Gynecomastia After Failed Liposuction By Other SurgeonRevision Gynecomastia After Liposuction and Partial Gland Excision By Other Surgeon.
Yes, there are many more examples of this technique on my website. Gland targeted first and almost all removed, the surrounding fat replacing that gland. I have never seen a crater deformity from my sculpture.
The technique does not stop in the operating room. Patient education, after surgery care,
Compression Garments,
Scar Care are but a few of the attention of detail that permits our patients to have maximum swelling at the time of surgery, quick recovery, and move on with their lives.
You will not find many of my patients on the forums to answer your questions. A few post but then disappear putting their gynecomastia behind them. However, there are many patients who have been willing to share
their gynecomastia surgery experiences on many pages of my website and in this forum. (Start at the first page and then follow the arrows).
But in the end, each surgeon has the methods he / she prefers. It is the result that counts. But that should be a result
- that a patient does not need to keep his arms down or not flex his muscles to hide deformity,
- a result that looks good from many different views and looks good even on animation while living life no longer hiding the chest with clothing,
- and a result that does not typically need so much bruising, swelling, and discomfort to get to the other side.
Hope this helps,
Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction
Topic: Gyno Surgery - Doctors and Technique (Read 4210 times)
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