I had gynecomastia surgery on February 7, 2008 at the office of Dr. Bermant in Richmond, Virginia. The following is a summary of my decision to get the surgery and my experience with Dr. Bermant. I hope this post will help others with their own decisions.
My ConditionI'm a 37 year old white male, 5'10" tall and 165 pounds. I had mild gynecomastia. It had not been a problem in high school or in my 20s. I think it developed very slowly over a long period of time. One day I noticed it and I didn't like it.
It wasn't very noticeable wearing regular shirts, but it was there. Sometimes, I would avoid buying certain shirts or close-fitting clothing because I felt my chest stood out too much. It wasn't a huge deal, but have been buying closer-fitting clothes lately and didn't like it. It also affected my confidence in my physical appearance.
The DecisionFor some time I had known about surgical correction of gynecomastia. Surgery is a big deal, however, and not a decision to take lightly. I Googled "gynecomastia" and found may great sites and forums for advice where I learned about the procedure and cost. For a few months I hemmed and hawed. I made my final decision one day in a taxi on a bumpy road. With every bounce of the taxi I felt my breasts jiggle. It was the last straw. "That's it. I'm doing it," I thought. My decision was made -- it was just a matter of timing and selecting a surgeon.
Surgeon SelectionA few years ago I helped to manage the care of a very ill family member, and one huge takeaway from that experience was that all doctors are NOT created equal. Some know more than others, some have more experience, some are better communicators, etc. I decided to do my research and pick a surgeon who had done hundreds of these procedures and developed a specialized practice on gyne. There is NO substitute for experience.
I spent quite a bit of time on gyne boards and surgeon websites. Dr. Bermant's site,
www.plasticsurgery4u.com, was by far the most comprehensive and informative. That was meaningful to me because of what it conveyed about Dr. Bermant's specialization and focus on gynecomastia surgery. I also found a few positive references to Dr. Bermant on different message boards. Lastly, I checked a medical website to see if Dr. Bermant had been the subject of any legal action but found none.
Since I live overseas, I made an appointment for a "Remote Consultation" with Dr. Bermant for $200. I took pictures of myself and sent in a questionnaire. During the call, Dr. Bermant impressed me with his extremely thorough explanation of the risks of surgery, alternatives to surgery and possible causes of my condition. Since my condition had developed well into adulthood, Dr. Bermant insisted that I rule out any other causes such as hormonal imbalances, cancer etc. He explained that surgery was pointless if I had a condition that would regrow the breast tissue after excision. He also pointed out that surgery is no guarantee that breast regrowth will not recur, or that everything would be perfect after the surgery. After the call I visited an endocrinologist and who ran some tests. She concluded that my gyne was "idiopathic," i.e. no apparent cause. Idiopathic gyne occurs in a sizable percentage of men as they age. Go figure. I decided to move forward with the surgery.
The SurgeryI traveled to Richmond in early February and checked into a hotel. The day before the surgery I visited Dr. Bermant's office for the the pre-op exam. His assistant, Jane, is an extraordinarily friendly person who is quite gifted at making people feel comfortable. Dr. Bermant examined my chest and made detailed measurements. Dr. Bermant is not a man for small talk -- he was all business and extremely focused on his work. He asked a series of questions and gave me an opportunity to ask my own questions. The whole pre-op too about 30 minutes and I was on my way.
The next day the surgery was uneventful. Dr. Bermant's OR staff were all courteous, friendly and professional. His anesthesiologist, Jim, was especially good at explaining his part of the procedure and guiding my expectations. I was pretty nervous because I've only had one minor outpatient surgery procedure before.
I entered the OR and chatted with the staff. The next thing I knew I was waking up and the procedure was over. As the staff helped me into some clothing, Dr. Bermant asked me proudly, "How is your new chest? Feel the contour!!" At that point my groggy-post anesthesia attitude was "I'll see it when I see it" but I lifted my hand to cop a feel on myself anyway. It was hard to tell with all the bandages, but there did seem to be real improvement. Clearly Dr. Bermant was very proud of his work and wanted me to check it out. He later told me he removed 100cc's and 150cc's of fat from the right and left breasts, respectively. The gland removal was something like 2x3x2 cm on each side.
Dr. Bermant's office arranged for a nurse, Michael, to drive me back to the hotel and spend the next 6 hours with me. Michael was a super nice guy and I enjoyed chatting with him. We went to dinner at a local Italian place that was excellent (don't remember the name, but ask Jane).
RecoverySurgery is no joke, and gyne surgery is no exception. That being said, the pain was material but not too bad. Imagine you have had the hardest chest workout of your life and you are extremely sore and tender -- it's like that, but maybe a little worse. Dr. Bermant gave me a prescription for pain medication which I used for a few days, mostly to sleep better.
One thing that Dr. Bermant puts great emphasis on is that patients must be "part of the team" in the recovery and care process. That means taking steps to ensure the best recovery possible, such as wearing a compression vest and massaging the surgery area. I wore the compression vest 24x7 for 4 weeks, then during the day for about 5 weeks after that. I highly recommend getting the "2nd stage" compression vest because it's much more comfortable than the first vest. I'm still massaging every night for 15 minutes each side.
Dr. Bermant stressed that I should contact him anytime with questions or concerns. I have, twice. Each time Dr. Bermant was exceptionally thorough in his answers.
Results86 days after my surgery I am pleased with the results. The gynecomastia is gone. My chest has a much more natural and "masculine" contour that fits well with the rest of my body. I can wear closer-fitting shirts now with no embarrassment. The scars are slight and fading. There is some hard scar tissue under my right nipple, but I'm hopeful that will soften over time with repeated massaging. On the down side, my nipples have still not recovered sensation -- I can't feel a thing. However, I know that sometimes it takes many months for nerves to regenerate and recover sensation so that still might happen. I'm prepared to accept it even if sensation doesn't return, though. The tissue under my nipples is still a tiny bit sore when I massage them, but otherwise they are back to normal.
My overall impression of Dr. Bermant is that he is a professional who takes great pride in his work. He does everything with exacting standards and is thorough and meticulous. If I had to choose again I would repeat my decision to get the surgery with Dr. Bermant.
My Learnings from the Experience
I don't give advice. However, I can share some of my learnings from the experience. They are:
* Pick the surgeon very carefully. Spending extra money for the best is worth every penny. After all, it's your body.
* Ask the surgeon lots of questions. Prepare a list and bring a notebook.
* Discuss expectations with the surgeon. Are there variables in the surgery that can raise or lower certain risks?
* Follow the surgeon's directions *exactly* before and after surgery
* My chest changed a lot in the months after surgery. Initial appearances are NOT an indication of what the final result will look like. I was surprised at how much the appearance changed in the first 3 months after surgery.