Making the MOST out of Compression Vests

[Sgt. Harry Balls]

Hi guys,

I read in a post somewhere that Dr Bermant said that when nurses/Dr first applies your compression vest you should have it done with your arms straight up in the air before relaxing. Are there any other tips from anyone here including Drs regarding wearing compression vests in the best possible way to get the best possible end result?

I plan to wear mine for 8 weeks religiously

[DrBermant]

Hi guys,

I read in a post somewhere that Dr Bermant said that when nurses/Dr first applies your compression vest you should have it done with your arms straight up in the air before relaxing. Are there any other tips from anyone here including Drs regarding wearing compression vests in the best possible way to get the best possible end result?

I plan to wear mine for 8 weeks religiously

After Gynecomastia Surgery Garments can help protect and with scar issues, but education enhances their effectiveness.

When we have our patients try on the garments before surgery, they can put their arms up in the air. Doing so after surgery makes no sense, especially in the operating room when the tissues are still numb and protective sensation of body limitations is not restored. So in the operating room, we never put the patient's arms up over their head after the sculpture. Instead we try to protect the recently sculpted tissues and not strain them. Once sensation returns, comfort can be a great guide as to how far tissues can be stressed.

Actually, that is part of my patient education. The documentation of flexing arms up over head before surgery becomes part of the education process the day after surgery to demonstrate the body's feedback on the limitations. I warn each patient only to put their arms up or flex as much as their body says it can be done (once numbness is resolved). Check the resulting photos that I document the day after surgery. They do not lift their arms all of the way up, they do not flex as tightly as they did before surgery protecting the tissues. On the next visit (when patients do come back and not do a dressing removal remotely), check the improvement in comfort range.

Patient education is a key element in the success I have seen over the years with my patients. It is in the details. The patient becomes a member of our team for his own sculpture. I have not doubt that the extra effort in this education has made a major factor in the results we are able to achieve.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[Sgt. Harry Balls]

Thanks for the speedy reply Bermant looks like I misunderstood what you said in the post I was referring to in my OP sorry about that and thanks for clearing that up.

[DrBermant]

Thanks for the speedy reply Bermant looks like I misunderstood what you said in the post I was referring to in my OP sorry about that and thanks for clearing that up.

You are quite welcome!

[Dr. Elliot Jacobs]

I have a totally different perspective.

I actually do ask my patients to s-l-o-w-l-y move their arms over their head right on the operating table.  This places the skin (which may be loose) on stretch and in the correct position.  Then a snug compression garment is applied to hold the skin in that position.  It is analogous to treating a fractured limb by aligning the bones and then applying a cast so that the bones heal unhindered in the correct position.

I do not believe that asking a patient to perform a routine and normal action is detrimental.  Obviously, vigorous up and down repeated movements will only produce more swelling, etc, and I do discourage that.

If you look at many of the before and after photos on my website, you can observe a significant skin tightening on many patients.  This, I believe, is helped by correct placement of the skin (which is very mobile after surgery) and then a snug garment to hold the skin in the correct position.

Dr Jacobs

[Sgt. Harry Balls]

Very interesting Elliott I will speak to my Surgeon regarding this see what he thinks also.

So by going what you've said would you recommend to your patience also do the same thing (raising arms above) when putting on the vest after a shower with a the help of someone else for the best resultS?

[Dr. Elliot Jacobs]

Yes, I always ask my patients to raise their arms before putting on the compression garment.  I have not any problems with this methods in thousands of patients.

Dr Jacobs

[dannyboy740]

Very interesting debate here.
The only prob I see with Dr Elliot's method is for guys who have had their surgery and have no help (ie they havent told anyone and have no help in putting their vest on)
When I was using the compression band I had to lay it on the bed, get on top and pull one side over before securing the other. I'd stand up and adjust if necessary.
I got a compression vest and this was great. Put it through both arms and then secure using metal fastners at the front. Overall this was better fr compression as the band could slip.

[Dr. Elliot Jacobs]

I recognize that if it is one person alone, it may be more difficult.  But with a little practice and perseverance, one can develop a routine and get it done alone.  Some guys will put the garment on, then raise one arm over the head and use the other hand to gently elevate the skin of the opposite chest (where the arm is raised) -- and then do the opposite chest the same way.

I have actually changed my methods slightly.  I have never been a fan of compression vests alone -- I find the compression inadequate.  Therefore, I now use both a compression vest (to provide some compression and to position the tissues properly) and then a binder on top to do the yeoman's compression work. 

By using these methods, and with very careful and meticulous surgery, I have been able to virtually eliminate the use of drains for my patients.

Dr Jacobs

[xoxoxoxo]

where can i buy compression vest here in california? i need it so badly 

[DrBermant]

Proof of concept about how effective a particular method is in the documentation. These are Pictures of Early After Surgery Swelling And Bruising using my techniques which include the compression garment management is use for my patients. Movies after Gynecomastia Surgery and pictures of muscles flexing and arms up over head are how I document tissue dynamics on the chest. Check to see such evolution of tissues and final results before deciding on a particular surgeon's method. I rarelyuse extra compression beyond the garment, perhaps once every 5 years or so.

My goal is to have not only the best possible result, but also the fastest least painful path to get there. With that my patients typically have peak swelling the day of surgery. That is giving the healing tissues the best chance to recover. In my early years of my practice for my hand surgery patients, that was not the case. There mobility trumped swelling in a delicate balancing act. Our physical therapists helped ride the fine line of that balancing act to hasten recovery and minimize swelling. That is why documentation of the recovery of the chest tissues with more than just one or two still picture views is so critical in understanding what you pay for and get with variations in methodology. For my gynecomastia patients, straining the healing tissues made little sense. They got back to work and play faster with less bruising and swelling by not pushing healing tissues. New swelling is a sign of new injury or loss of protection. I have see many early after surgery pictures of other doctors' work mainly on forums since few seem to post such views on their own sites. I have yet to see anyone's methodology excel beyond what my documentation demonstrates (which is typical for my patients).

Very interesting debate here.
The only prob I see with Dr Elliot's method is for guys who have had their surgery and have no help (ie they havent told anyone and have no help in putting their vest on)
When I was using the compression band I had to lay it on the bed, get on top and pull one side over before securing the other. I'd stand up and adjust if necessary.
I got a compression vest and this was great. Put it through both arms and then secure using metal fastners at the front. Overall this was better fr compression as the band could slip.

For my patients, each is fitted with their garments before the operation and we place the first stage garment on the operating table. The day after surgery each patient's education continues with a practical exercise of demonstration of listening to their body about limitations of activity and getting the garment back on by themselves. So many of my men come by themselves and others need to learn what limitations of garment changing is like if someone was not there.

The upper strap adjustment is best done with the garment on. This is not reasonable for a patient to perform by themselves. That is why I ask my patients to leave the adjustment where we set it or if they are going to change it afterward to do so with the garment off so they do not need to reach over their shoulder. Having another person to help is another option for that adjustment.

where can i buy compression vest here in california? i need it so badly 

First Stage Gynecomastia Garment

Second Stage Gynecomastia Garment

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction