Anyone know if anyone is actually researching alternate methods for removing tissue? Or if we, collectively, can pool together some ideas? Any researchers? Med students here?
There are many who continue to research alternate methods to remove gynecomastia. This has been one of my passions for decades. The search begins with what is in the literature. I did not like the extremely high revision rates I quote in this post here:
https://www.gynecomastia.org/smf/index.php?topic=21754.msg147318;topicseen#msg147318I also did not like the high rates of recurrence seen in the literature and from patients coming to me after recurrences by other doctors. I then set out to evolve a methodology to document a patient's specific gynecomastia history and exam. I evolved a series of measurements to define the problem and surgical solution. My
Standard Pictures evolved over the years to special sets for the drooping male chest, then revision gynecomastia surgery. How tissues moved evolved from images to
Standard Movies for Gynecomastia which then added the emotional component of the problem before, the surgical process, and the healing after. I have been keeping track of the comfort of the patients, bruising, healing, and sculpture evolution. I have posted such picture progression and videos on my site. Working with a number of endocrinologists I evolved my
Red Flag System for evaluation to minimize which patients needed Endocrine evaluations. This method was received well during my invited Gynecomastia lecture at the American Association Of Clinical Endocrinologists 2008 national meeting.
I challenged what was in the literature where many start with the liposuction component first and then take gland by evolving my
Dynamic Technique about which I have lectured and published. By targeting gland first, with the specific variations in tumescent technique, and patient education I have achieved my goals of decreasing bruising, increasing comfort after surgery, and limiting the need for revision operations, cortisone injections, or subsequent recurrence.
Over the past 14 years my research also has been in the area of public education about what plastic surgery has to offer. Through building a massive web site, posting on forums, and conversations with other Plastic Surgeons, I am happy with what has changed over the years. Take a look back on this forum itself, look at older posts by using the search function for oldest posts first and compare to what is going on now to see the evolution of what has been done for this surgery. Make is simple and look for pain / comfort and time of use of pain pills.
Some of my patients have taken years before they come in for some operations. Watching the evolution in my own documentation techniques has also been fascinating as I update their details during examination or evaluation.
That is what non academic clinical research can offer. Review what is being done, postulate a different method, evolve documentation to see what that method offers, and then share the information with others. Continued evaluation, re-evaluation, cross specialization education, and discussion of problem cases further helps refine what surgeons and endocrinologists have to offer.
And I'm wondering if I can donate my body to gynecomastia research - does it sound unlikely that volunteers will be sought?
Some places such as centers that train doctors may offer reduced rates. However, the surgeon performing the operation usually will have limited experience. The supervising physician may be responsible, but this is a hands on sculpture skill. Yet, many of the finest sculptures of history had journeymen helpers creating the work.
Hope this helps,
Michael Bermant, MD
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