I found you website tonight, and I was really excited to find a doctor that understood exactly what a patient requires for best results. My son (almost 20) needs the surgery but wants to lose a substantial amount of weight first. His gynecomastia appears to have a glandular component and is not just fat. He has very pronounced, pointed breasts that appear to be quite firm. (Some of this is conjecture on my part, as he NEVER takes his shirt off where anyone can see.) He has had this problem for years, even before he gained a lot of weight.
We consulted a local plastic surgeon, but he spoke only of liposuction and local anesthetic. I do not believe that lipo alone will resolve the problem, based on everything I have read. Also, my son was terrified at the thought of enduring the procedure with nothing but a local anesthetic.
I thought Dr. Bermant was going to be the perfect choice to help my son, even though we live in Oregon, and then I saw that he is retiring this summer. My son will need more than a few months to lose enough weight, I think, plus we would need to save enough money to pay for it. I could probably manage the money by August, but he needs to lose about 100 pounds, and I don't see how he could lose that much that fast.
I was hoping that you might have some advice for us. I am assuming that weight loss prior to surgery is very important for good results -- that's what they told him here. He weighs about 320 and is 6'3".
What do you think we should do? Is there anyone on the west coast you could recommend, since it seems unlikely that we will be able to get my son in before Dr. Bermant retires.
Thank your for you kind words about my surgical sculpture skills. I do see many patients from around the world who prefer my techniques. And we are seeing many asking us to fit them in before my retirement.
In general, weight loss should be considered first. Check out this new resource I just made about Gynecomastia Surgery
and look at the weight loss section. You are right about the liposuction not removing the gland. I have seen so many patients unhappy after attempts by other doctors with that method. Male Body Fat Distribution
tends to put fat first on the breast and belly. We take it off those regions last. Surgery is not a replacement for weight loss. Take off enough to let the muscles through, and the body will look strange with the imbalance. Take the fat down to the global element and then lose weight? If the weight comes off in the normal pattern, and the breast fat does not come off as well, then it will look like the gynecomastia has returned.
My recommendation is that patients get to a weight they are happy with before considering surgery. This means considering the Body Mass Index
and Body Fat Analysis
. Once this has stabilized and skin has stopped shrinking, then consider surgery. I consider this body sculpture and prefer to use the coarse tool first (weight loss), and then the refinement (plastic surgery), second.
Yes, I am coming up on my Retirement
at the end of August 2011, but that does not mean anything can nor should be rushed in the natural process for body sculpting.
I have posted two resources you may find of value in Choosing Your Gynecomastia Surgeon
and Evaluating Gynecomastia Pictures
to better understand that surgeon's skills. Body Shaping Garments
are a great temporizing contouring alternative while trying to love weight.
Hope this helps,
Michael Bermant, MDLearn More About Gynecomastia and Male Breast Reduction