Author Topic: Experience with Dr. Bermant  (Read 9407 times)

Offline azuzuru

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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 Condition

I'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 Decision
For 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 Selection
A 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 Surgery

I 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).

Recovery
Surgery 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.

Results
86 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.

Offline trojan213

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Wow awesome post! (Are you a consultant btw? :P)

Congrats on you surgery and thanks for posting about your experience

P.S. Do you have pics that you can share?

Offline gynoprison

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Congratulations on the success of your surgery.Dr Bermant is the doctor I should have went to. I elected to stay in my town/state, and at ten months post op, i regret it. I may be in the position to get revision surgery, but now we are talking about paying the full cost of another surgery.  :(

In the words of Bon Jovi, "it's my life it's now or never, i ain't gonna live forever, I just want to live while i'm alive."

Offline mizuno

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If you can try to post some pics.
But congrats anways.

Offline azuzuru

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Here are my pics.  I've organized each shot chronologically pre-op to post-op.  Just read the captions.  Let me know if you have any questions.

http://tinyurl.com/5wbmuc

Cheers,
azuzuru
« Last Edit: May 06, 2008, 11:56:49 AM by azuzuru »

Offline gynoprison

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That's Dr Bermant's work? Now I have no doubt i should have went to him.That's ace's man.Again congrats.

Offline trojan213

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Here are my pics.  I've organized each shot chronologically pre-op to post-op.  Just read the captions.  Let me know if you have any questions.

http://tinyurl.com/5wbmuc

Cheers,
azuzuru

Thanks for posting. Your results look amazing. Congratulations! I'm pretty convinced now that I'll fly from NY to Virginia to have surgery with Bermant. Awesome awesome stuff.

Just some quick questions - How long before you flew home? How is the scarring? Are the scars getting less visible? Do you feel any significant scar tissue? How long was it before you were working out at the gym? Lifting weights?

Thanks again

Offline what2do?

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wow, amazing results.. soo weired how the reduction of breat tissue alone makes one look SOO much slimmer overall ..

Offline azuzuru

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Yeah, I can't tell you how many comments I've received since I've had the surgery -- "Wow, you look so slim" and "You look great" even though I'm about the same weight, maybe just a few pounds slimmer.  Reduction of breast tissue makes a big difference in your physical appearance.

Btw, I'm 5'10" and now weigh 163 lbs.  The pre-op pics were taken about a year ago when I weighed in at about 172 lbs.  Just before the surgery I weighed about 167 lbs.  The weight loss is not from the surgery -- just eating better and exercising more.

I flew home about 5 days after the surgery.  I live in Asia so it was a long-ass flight.  But no problems -- it was pretty comfortable.  Fortunately, the little metal hooks in the first compression vest didn't set off the metal detector at airport security.

I'm pretty lazy so I don't work out.  My exercise consists of walking a lot and dancing 3+ nights/week (swing and salsa).  It's great exercise, fun as hell and a great way to meet girls :-). 

I have some subdermal scar tissue about the size of a kidney bean under the bottom edge of my right nipple.  I'm massaging that regularly in the hopes it will soften and dissipate.  The left nipple has very little if any subdermal scar tissue.  Surface scars are small and slowly fading (check the pics carefully).

If you are considering Dr. Bermant, one thing to bear in mind is he *really* is not a man for small talk.  He is all business and, to use a phrase of speech, does not suffer fools gladly.  Research things well on the net and on his site before you visit.  Have your questions prepared in advance (I recommend writing them down in a notebook).  Dr. Bermant has little patience for answering the same question repeatedly, or being asked a question covered in his website or written FAQ (you will receive some written FAQs in his office at the pre-op appt).    Be precise and to the point in your communications with him.  I found that my relationship with him was very clinical and professional, which was fine with me.

That said, it was clear to me that Dr. Bermant cares a great deal about his patients and takes real professional pride in his work. 

Cheers guys, and let me know if I can answer any other questions.

azuzuru




« Last Edit: May 08, 2008, 02:16:46 PM by azuzuru »

Offline S.ken

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Very nice. I should check this guy out. How much was surgery?

Offline azuzuru

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All-in costs were $6200.  Worth every penny.

Offline azuzuru

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Here is a message I sent to someone who private-messaged me with scar concerns.

Hi John Smith,

It seems your primary concern is scarring.  My experience has been that the scars are  light and continue to fade 4 months after surgery.  I've been with a few women in the past month or two and none of them said anything about my nipples.  I have a somewhat hairy chest, so the hair partly conceals the scar area making it even less noticeable.

After surgery your chest will continue to evolve significantly for 6 months.  I was a little freaked out when I took off the bandages for the first time because my nipples looked so weird (check the pics, I have a nipple pic there right after I took off the bandages).  But over time they returned to normal.  Absolutely KEY is following the PS's directions exactly after surgery. Dr. Bermant suggests wearing the compression vest for as long as you can.  Constant compression promotes softer and less prominent scars.  Another key is massaging the scar area every day.  That also softens the scar.  You should not expose your nipples to sunlight for at least 6 months, as that may cause permanent darkening of scar tissue.  Dr. Bermant gives detailed written instructions on post-surgery care.

I am very satisfied with the results.  I would be confident exposing my chest anywhere, with little concern that my scars are noticeable.  One big drawback to the surgery, though, is that I have lost a lot of nipple sensation.  About 60% sensation has returned in my right nipple but my left nipple is still numb.  That's a bummer, but to me it was worth the results.

Whether your experience will be the same as mine, no one knows.  As Dr. Bermant will tell you, everyone is different and heals differently.  Dr. Bermant will not guarantee results and will not tell you that your scars will not be noticeable.  I respect that about him -- he doesn't sugar-coat anything.

The only advice I can give is you should decide to move forward only if you've researched all the risks, thought about them, and accepted them.  Part of that research could include a consult visit to Dr. Bermant or a remote consultation with him like I did.  Good luck with your decision!

Cheers,
Azuzuru

Offline Gcp

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All-in costs were $6200.  Worth every penny.

Not bad.

Offline tenncast

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great results...

I too had surgery with Dr Bermant...you descibe him perfectly. I agree that I want someone who is more clinical in the approach. I visited too many doctors that seemed to think that they could do a good job without really assessing my situation.

I should post pics too.


Offline mizuno

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tenncast - please do


 

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