First Consultation with a PS (long)

[Spleen]

Hey you all,

Went for my first plastic surgery consulation yesterday.  For a little background I am a 36 year old married father of 3, 6'1" 235 pounds (weightlifter).  My body fat is a little high at the moment since I'm in a growth phase, but as a long time wrestler cutting weight is something I'm used to.  I go up & down between 200 & 240 depending on my diet and workouts and if I'm fighting in a particulat weightclass.  My issue is mostly with my "puffy nipples".  Had 'em since I was a kid and whatever my weight, fitness or body fat % has been they stick out like tee-pees.  I'm certain I just have too much gland right beneath them.  Never took a 'roid and hormone levels all normal.

I thought I'd look for a good PS here in South Florida before committing to traveling to someone like Bermant.  I found a few PS down here who showed some Gynecomastia corrections on their sites, so my plan is to visit 3 or 4 of them and see if anyone rates.

So my first visit was to a doc about 30 minutes from me in a ritzy town.  They guy has great credentials, education and is board certified.  I asked on the phone how many gynecomastia cases does he does a year, but they asked me just to come in for a free consultation.  The offices were very nice and the staff very gracious.  Definately a professional outfit.  After filling out a brief questionnaire about my medical history I was moved to an examination room.

The doc came in and greeted me and just ran thru a couple more questions.  He looked at my torso for about 30 seconds before we even made eye contact.  The first thing he said was "man, you'll be easy, you should have seen the guy we had in here a couple days ago".  Then he asked if I wanted to lipo the belly too.  I said I probably would since I'd already be there, but it would depend on cost, recovery, etc.  I figure I might as well since even when I've been less than 10% body fat the only chunky place on my is the center of my belly.  I can be ripped everywhere else and still not show any abs.  My guess is the gyne cases he deals with are mostly related to obesity.

He then took some measurements from my chest to my hips and went over how the surgery is done, what recovery time is like, etc.  Most of this I already knew from doing my homework before hand.  As he finished his spiel I asked how many gynecomastia cases does he do a year.  He said not very many.  I then reiterated that my goal wasn't as much lipo as it was fixing the nipples and getting them flat.  I thought excision plus lipo would be the way to go.  He said that he didn't think my case was that bad and that I ought to have realistic expectations.  He thought lipo would do the trick and that I wouldn't want the chest of a little boy.  I agreed (and at my size little boy is the least of my worries) but stated again that it was the puffy nips that were the impetus for seeking a PS consult.  He palpated my nipples and said he didn't think the gland was very big, but said he could remove gland if I wanted.

After we shook hands I met with his assitant who talked price and scheduling.  $6000 K for chest and abdomen lipo with excision (if necessary), inclusive.

I think I learned a few things from this meeting.  First, even well qualified plastic surgeons with generally excellent outcomes in various surgeries may not have sufficient experience with gynecomastia correction.  In particular his immediate interest in doing lipo with no mention of gland excision tipped me to this.  How many times have we seen guys who post here say that they had surgery but were disappointed that the pointy nips remained?  In almost every case we hear that they has just lipo.  I am certain that if I went with this guy I'd have a flat gut, a less fatty chest, and the same nips as I began with.  He seemed perfectly confident that we'd acheive the desired result, but my feeling is that his honest admission of working few gynecomastia cases meant that the issue here was not if he knew what he was doing, but if there were things he ought to know about gyne and didn't.  He was a fine doctor and I bet he'd be great for a tummy tuck, breast job or lipo, but for my needs it was a definite "no".

So now to make a few more appointments.  Hopefully I'll find someone I feel confident in, but if not I'll probably end up travelling to one of the 4 or 5 surgeons that seem to have real expertise in this area.

[Daveo]

Sounds like you made the right choice.

[jc71]

Good for you Spleen.  Sounds like you learned a good lesson. I guess it's important to go with your gut feeling than be taken by a fancy office.  Sounds like he was side-stepping your question a little bit and the fact that he didn't look you in the eyes at first doesn't help his cause either.

South Fla? I'd think there'd be some pretty good surgeons down there. Way to do your homework. You're right, if your problem is puffy nips, you probably will need someone skilled on excision, not just lypo.  

[Spleen]

Again, I think this guy was probably a very good plastic surgeon, but it just hammers home that experience is everything.  My feeling is that there the surgeons who know the best techniques to address this condition are few.  I hope that guys like Bermant lead seminars for other plastic surgeons teaching their peers how to address this condition.  Maybe they will (if they haven't already) write for the medical journals and periodicals.  I wonder if maybe there isn't a pretty wide gap between the surgeons who specialize in gynecomastia correction and everyone else.