The Last Stretch...

[ThatOneGuy]

So, I went to go see a local surgeon a few months ago and got my case assessed, and now my family and I are looking at going through with it.

Just one little problem: money. 

My dad is understanding of the fact that Gyne isn't just fat, but refuses to pay for any of the surgery because he still doesn't think I should go through with it.

My mom is also understanding and would pay for it, but is in the middle of paying for several big house improvements and such, so she really can't afford it right now, and I'm 16 and jobless. So I can't pay for it either.

So the only real option right now is insurance, which the Dr. said would only likely cover the gland excision and nothing else. Which is another problem, as I'm overweight and my body decided to store a lot of fat in my chest in addition to the "lemon sized" glands in there.

So just excising the gland would leave big ol' holes in the middle of big ol' pockets of fat.

Now I'm of course going to get back on my weight loss schedule soon, so one could argue that with enough diet and exercise, the fat would go away, but chest fat is almost always the last to go.

My mom and a couple doctors are ready to appeal when the insurance almost inevitably denies our request, however. I've got a psychiatrist who is prepared to write a letter describing the mental and emotional pain that this has caused me, and my family's physician is okay with writing a letter describing the physical pain that Gyne causes me (it seriously does, too).

So, I just wanted to ask, is there anything else I should try and use to my advantage? Or maybe could someone give me an honest estimate of my chances of success here?

I just want to be rid of these things already.   

[Dr. Elliot Jacobs]

A real dilemma for you -- so sorry.

If you are overweight, then absolutely your insurance company will deny you.  Therefore, lose the weight -- somehow.  Once the weight is lost, you will need documentation of your problem from a plastic surgeon, endocrinologist and mental health professional.  A note from you as well, indicating any real breast pain or tenderness will help.

And then, quite honestly, it is a crap shoot.  The vast majority of my patients are turned down -- insurance companies are not your friend and are loathe to pay for elective surgery. They will use any excuse not to provide reimbursement to you. Once in a blue moon, for unknown reasons, an insurance company may cover part of the expense -- but understand this is extremely rare.

But first-- the weight loss.

Dr Jacobs

[jojo82]

So, I went to go see a local surgeon a few months ago and got my case assessed, and now my family and I are looking at going through with it.

Just one little problem: money. 

My dad is understanding of the fact that Gyne isn't just fat, but refuses to pay for any of the surgery because he still doesn't think I should go through with it.

My mom is also understanding and would pay for it, but is in the middle of paying for several big house improvements and such, so she really can't afford it right now, and I'm 16 and jobless. So I can't pay for it either.

So the only real option right now is insurance, which the Dr. said would only likely cover the gland excision and nothing else. Which is another problem, as I'm overweight and my body decided to store a lot of fat in my chest in addition to the "lemon sized" glands in there.

So just excising the gland would leave big ol' holes in the middle of big ol' pockets of fat.

Now I'm of course going to get back on my weight loss schedule soon, so one could argue that with enough diet and exercise, the fat would go away, but chest fat is almost always the last to go.

My mom and a couple doctors are ready to appeal when the insurance almost inevitably denies our request, however. I've got a psychiatrist who is prepared to write a letter describing the mental and emotional pain that this has caused me, and my family's physician is okay with writing a letter describing the physical pain that Gyne causes me (it seriously does, too).

So, I just wanted to ask, is there anything else I should try and use to my advantage? Or maybe could someone give me an honest estimate of my chances of success here?

I just want to be rid of these things already.   

Go to a local medical college and ask to be scheduled in the plastic surgery clinic. Ask if the chair of the dept and other managing surgeons have experience with gynecomastia. They probably do. Schedule the surgery there with a resident.

Despite what some of the salesmen say (some of these surgeons have staff write these comments), gynecomastia surgery is not rocket science. The techniques used today have been around for decades. Just make sure that the managing surgeon/professor has experience with gynecomastia surgery.

[Dr. Elliot Jacobs]

jojo82  is right in some respects -- and in error on others.

Plastic surgery residencies help to train plastic surgeons.  They often have clinics which offer reduced rates for cosmetic surgery.  The reason is that the residents are learning -- they are not yet experts.  And even though every procedure is overseen by a senior surgeon, it is the resident plastic surgeon who wields the scalpel and scissor.  And one wrong move......need I say more?  And if something does not heal well, try to find the resident -- who has now graduated and moved to another state. I know this because I went through it myself.  And how many gyne procedures did I do during my three year plastic surgery residency?  One!

It does not take a rocket scientist to know that to be good at anything, you have to do lots of it.  You cannot compare the abilities of an experienced surgeon (after thousands of gyne operations) to a plastic surgery resident -- who has, at best, a very limited number of procedures under his belt. 

The old adage holds true:  you get what you pay for.  And as many people on this forum have written, they went for someone whose fee was very low in an effort to be able to afford the procedure -- and ended up with poor results that they had to live with or they had to pay additionally to have the first operation corrected. 

Many surgeons and other guys have written on this forum that the best opportunity to get a fine result is to go to an experienced gyne surgeon.  There is, indeed, an art to doing these operations.  And while it may not be rocket science, it does demand skill, expertise and experience, which is not possessed by a resident.

Oh, by the way, I write every one of my posts myself.  Would you think that a member of my staff is writing this at 9pm on a Saturday night??

Dr Jacobs

[BeLikeArnold]

I believe it! Dr. Jacobs loves what he does!

[jojo82]

jojo82  is right in some respects -- and in error on others.

Plastic surgery residencies help to train plastic surgeons.  They often have clinics which offer reduced rates for cosmetic surgery.  The reason is that the residents are learning -- they are not yet experts.  And even though every procedure is overseen by a senior surgeon, it is the resident plastic surgeon who wields the scalpel and scissor.  And one wrong move......need I say more?  And if something does not heal well, try to find the resident -- who has now graduated and moved to another state. I know this because I went through it myself.  And how many gyne procedures did I do during my three year plastic surgery residency?  One!

It does not take a rocket scientist to know that to be good at anything, you have to do lots of it.  You cannot compare the abilities of an experienced surgeon (after thousands of gyne operations) to a plastic surgery resident -- who has, at best, a very limited number of procedures under his belt.  

The old adage holds true:  you get what you pay for.  And as many people on this forum have written, they went for someone whose fee was very low in an effort to be able to afford the procedure -- and ended up with poor results that they had to live with or they had to pay additionally to have the first operation corrected.  

Many surgeons and other guys have written on this forum that the best opportunity to get a fine result is to go to an experienced gyne surgeon.  There is, indeed, an art to doing these operations.  And while it may not be rocket science, it does demand skill, expertise and experience, which is not possessed by a resident.

Oh, by the way, I write every one of my posts myself.  Would you think that a member of my staff is writing this at 9pm on a Saturday night??

Dr Jacobs

My comment was in no way directed at you. Your work is top-notch from what I've seen with your before and after photos.

My main concern as an advocate is helping gynecomastia sufferers- not all sufferers can afford the best plastic surgeons who specialize in gynecomastia. It's easy to forget just how emotionally crippling this condition is, especially for men who suffer with type III or IV gynecomastia. For these men, a plastic surgery clinic is perfectly acceptable and the cost is often half of what many on this forum charge. The result is also perfectly acceptable in most cases.

And re: the staff comment- I have some experience with this, so I know it's true of many practices. Again, I was not applying that to yours.

Dr. Jacobs: in an unrelated matter, can you please contact me via this forum? I have something important to discuss.

[Dr. Elliot Jacobs]

I have many times recommended local plastic surgery clinics to patients who lived far from NYC or who could not afford my private fees.  My only concern is that one should approach these clinics with an open mind and a thorough understanding that the surgeon may not have much experience in gyne surgery.  However, it is a good way to save money or make the surgery affordable.

For those who go to these clinics, however, there is a caveat.  The best chance for a good result is with an experienced gyne surgeon.  If you find yourself needing a revision, then it can be expensive and you are always playing catch-up.  I often counsel my patients, if they are in any way flummoxed, to delay surgery, save their money and go to a real expert.  It is smarter in the long run.

Dr. Jacobs: in an unrelated matter, can you please contact me via this forum? I have something important to discuss.

jojo82 -- if you have anything private to discuss, please send me a PM.  Thanks

Dr Jacobs