Due Diligence

[speedracer22]

Interested in getting specific decisions / considerations that I should address during a couple of consultations.

Probably looking at gland excision and puffy nipples. 40 y.o., good health and weight.

1. Other than input from this forum, and before and after images from the Doctor, how does one evaluate a Doctor?

2. I think the posters are sort of self-selecting group in the sense that bad experiences are less likely to be inclined to participate. I'm sure the "move on with their life" theory is correct for successful experiences but still think they would be inclined to post back. So. How can one truly evaluate the risks of the surgery?

3. Is consulting an endocrinologist highly recommended and why don't I hear much about people altering their diets etcetera for issues other than weight loss?

4. What is the risk of re-occurence, is it strictly hormonally-based and why wouldn't a physician be able to anticipate re-occurence?

5. Other than sloppy work, what are the issues involved in not having "craters" and disformity?

6. Should one do nipples at the same time as excision and what are the considerations for this procedure?

Thanks.

[outertrial]

1. Through consultations (have more than one), and word of mouth.

2. Its not dangerous surgery for a good surgeon however it is tricky to get right, the risks are as stated. i.e the possibility the problem is not resolved or causes deformities.

3. Yes, and you do, people are forever talking about diet.

4. Slight if you dont have a hormone problem. Gynecomastia is idiopathic, in most cases there is no obvious cause and no way to evaluate reoccurence other than it is unusual.

5. A good surgeon.

6."do nipples"?

[speedracer22]

Hi. Much thanks for the assistance. I much appreciate it.

Happy to get additional input on this.

Quick follow ups:

3. I actually forget what I was driving at with this one. I guess consultation with an endocrinologist would tell you if you had a hormone imbalance is that it? If one did have an imbalance would it be advisable not to get surgery due to a high probability of re-occurrence? Also, is shopping for a good endocrinologist as important as shopping for a good doctor? Finally, do folks do "proactive" diet things such as taking hormones or pills etc that will lessen the gynecomastia and also do "reactive" things such as cutting things out of one's diet?  Or is this a case where you've had it since adolescence and surgery is essentially the method of eliminating it?

4. I totally do not want to get into a scenario where I become preoccupied with this because it is changing, hurting, re-occurring etc. A. How do I know that re-occurence is unusual? B. Do Doctors ever recommend against surgery due to a high risk or re-occurrence? And if so, is this because it is not "idiopathic" but due to some hormone imbalance?

6. Saw the "puffy nipple" surgery on Dr. Berman's site and was wondering if this is something that one would do at the same time as excision and/or whether this was a special(ized) procedure that one would want to have done separately or fi one should have it be a large consideration in choosing a surgeon.

Again much athanks.

[speedracer22]

Hi Dude.

Thanks for the input. I definitely would like to hear back from the previous poster as well as anyone that can add information to the original post and follow-up questions.

Don't want to hijack my own post, however, my thought is to definitely research this as much as possible (despite not really wanting to have to).

Two things strike me.

1. There must be studies regarding issues related to the surgery and if not it seems like an oversight on the part of the profession.
2. Hard to know who's who on a forum such as this.

Any event. Much value the input and definitely would like to get answers to the original post , the follow up and comments on these.

BTW. I'm strongly inclined to go the route you've taken after emotionally putting it back on the back burner for some time recently.

[steve6161]

I agree with what people here have posted.
I'm 5 days post op. I've had this since I was a kid and have waited 25+ years. I wish I had taken care of it sooner.
I can tell you that I have no regrets. Plastic surgery has evolved quite a bit and the procedures are safe and are being done on hundreds of thousands of people in the US every year. (That said, there are of course risks that you need to come to grips with beforehand.)

In terms of due diligence I would:
- Choose a board certified plastic surgeon. They've gone through a long and arduous internship specifically in plastic surgery.
- Interview many doctors. Make sure they have good resumes, are knowledgeable and can answer all your questions to your satisfaction. Ask them point blank if they have had any patients with problems.
- Check out the before/after photos. if they don't have a number of them move on.
- Personally speak with at least 2-3 people who have had the operation you are considering from the doctor. Make sure they are enthusiastic. If the doctor can't produce enthusiastic fans find one who can.
- Check out doctor ratings sites such as www.ratemds.com and other sites. There are also local sites like www.citysearch.com where people post reviews of doctors (along with restaurants, etc.) Google your doctor and find out what you can. The doctor's state will also have a medical license board that will show what the doctor is board certified in and if there are any complaints against them.

[matthew1]

1. Through consultations (have more than one), and word of mouth.

2. Its not dangerous surgery for a good surgeon however it is tricky to get right, the risks are as stated. i.e the possibility the problem is not resolved or causes deformities.

3. Yes, and you do, people are forever talking about diet.

4. Slight if you dont have a hormone problem. Gynecomastia is idiopathic, in most cases there is no obvious cause and no way to evaluate reoccurence other than it is unusual.

5. A good surgeon.

6."do nipples"?

''idiopathic''    ok mr big word,  can you  dumd this  term  down a little for guys like me>?
   I see idiot in idiopathic,   

[outertrial]

Its a term used in medicine to mean  there is no obvious cause for the disease.

As far as hormones and reoccurence OP. Unless you have obvious symptoms of something like Klinefelters, in which case gyne would be only one of a number of strongly feminised characteristics (small testes, curved hips etc) , its quite unlikely that theres anything wrong with your hormones. A GP can do a blood test, its not a big deal. Very very few people here  have hormone problems though some men do take oestrogen to try and grow breasts. God alone knows why.

The chances of it growing back are slight. If there were any problems with your hormones   there is treatment to correct that.

Puffy nipples are caused by gland, normally this is removed during surgery along with everything else.

[Grandpa Bambu]

''idiopathic''    ok mr big word,  can you  dumd this  term  down a little for guys like me>?
   I see idiot in idiopathic,

There are online dictionaries dude... 

GB

[Grandpa Bambu]

Its a term used in medicine to mean  there is no obvious cause for the disease.

Gynecomastia is not a 'disease'.

GB

[outertrial]

Certainly caused me dis-ease.

[Grandpa Bambu]

Certainly caused me dis-ease.

 

GB

[enthusiastic]

I'm 32 and I'm going to get surgery Oct 2nd.  I too am tired of living with this.   I'm ready to just put it in the past.

Also, your'e right, even if it doesn't turn out pretty I'm out 7grand and I could wear just a t-shirt for the first time in my life.   

I'm going for it.