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Topics - DrBermant

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31
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Hi Dr. Bermant,
I came across your website while researching revision otoplasty.   I see that you are retired.   I'm wondering if there is another expert plastic surgeon that you would recommend for this procedure.   Your name comes up in just about every google search on the topic.   My 11 year old daughter is in need of revision otoplasty on one ear, her original surgery was not good.
Thank you,

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

Sorry, specific doctor name recommendations is a form of medical advice that retired, I no longer offer. However, I have built a resource where I can share my knowledge and experience here on the forums. Our forums are a meeting place where individuals like yourselves can post problems and images to show others their concerns.

Deformity after ear surgery can take many forms. Posting a set of Standard Otoplasty Pictures as well as the before surgery images can help define the original problem and the current deformity. Details of what was done surgically can also help define what happened. Posting pictures can be part of the learning process of what to look for in How to Evaluate Ear Surgeon Before After Otoplasty Pictures

Yes, it can be difficult finding surgeons who have a passion for Revision Otoplasty. Fixing bad ear surgery is a demanding art. Not all surgeons have the same skills. I have posted tools on How to Pick your Otoplasty Surgeon. A major issue on selecting a doctor is to see their skills at fixing specific problems. That is where the photos come in. How has your searching done in coming up with documentation of Otoplasty Complications? Each time I have searched, not a topic well covered. When I find a rare page typically there is little there that comes close to the critical before after photographs I used to define my patients' problems and solutions.

Empowering the Public
This forum is also a place where those surgeons who have a passion to post examples of their skills at addressing such deformities. Not all surgeons know how to make their own websites. Building websites can be expensive, especially for rare problems.  This forum is a public meeting ground, for those with problems and those who have solutions to share. Perhaps you can find a referral service or hope an Internet search shows you some doctor. Or, take the matter in your own hands and contribute to this expanding resource and tool for those trying to define and solve problems.

Beyond the learning experience about this ear and finding your own revision surgeon, posting here may show others what happened and try to prevent a similar issue in the future. What went wrong? Does the ear look like the doctor's before after photos? If no why not? Education can be part of the process of preventing an even worse deformity when seeking further surgery.

Hope this helps,

Michael Bermant, MD
Retired Plastic Surgeon
Learn More About Otoplasty Ear Surgery

32
This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

I accepted your invitation to connect on LinkedIn.

Naturalism Furniture I like your sculpture enough willing to exchange links. I have taken the first step and discussed the concept and linked to your site here on the forum. My sculpture is that of the human body, also organic in design, but of still living tissue.

The page your site would be linked on is for such artistic design: Illustration Art Artists and Companies . That placement might change when I add something closer to organic art beyond medical. It is a new resource page, but better more specific vs one of my older pages less related like: Other Sites of Interest.

I like your individual pieces galleries, but your site lacking in the gallery of gallery navigation, hit and miss just by numbers.

I use many types of galleries on my sites for comparison of pieces. If you want to discuss such issues here is a forum I have that permits such Artistic Creativity Talk Forum

the page on your site I would like to see my main site listed would be: Naturalism Furniture Links

Plastic Surgery Body Sculpture Encyclopedia
Michael Bermant, MD
Retired Plastic Surgeon

here are some of my galleries
Gynecomastia Gallery each image links to the specific patient gallery page, but unlike your main linking page, the viewer gets a chance to pick where they are going. That page is the old style with non dynamic pages below the page are some of the other galleries.

here is one of the newer ones
Bruising Swelling Recovery After Tummy Tuck Picture Gallery

here is a unifying gallery collection for tummy tuck videos and static photos and videos where the viewer knows what they are going to see vs just a number:
Before After Photo and Movie Gallery. There is a concept I have yet to see applied to furniture. videos showing how the piece functions in real life, how it moves, drawers open, how something works, walking around the piece, how a body talking or performing is set off by the piece, and so forth.

or for those willing to go into the operating room to see what the sculpture is like in gallery mode (caution graphic photos):
Anatomy of Tummy Tuck, in your case, how the piece was made, photos during evolution and building the piece.

If interested let me know or discuss it here.

Hope this helps,

Michael Bermant, MD
Retired Plastic Surgeon
Learn More About Plastic Surgery

34
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Are you considering plastic surgery? yes, within 6 months
Age: 35-39
Gender: Male
Question: I was just curious if Dr.Berment was still practicing ?  Some articles say he retired. I am in need of gynocomastia surgery. I am in Columbia Sc.   It is there from steroids I took over 20 years ago. Thanks

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

Steroids are Among Medications That Cause Gynecomastia by disrupting the delicate balance of the endocrine system. For many what has grown, just does not go away once the active phase has passed. Some patients even though they stopped the steroids still had tender breasts years later. That would have been a Red Flag requiring an Endocrinology evaluation before considering surgery.

Yes, I retired Retired My Practice of Plastic Surgery on August 31, 2011. I still try to share my knowledge and experiences on forums and build resources for the public to better learn about their options. But, I no longer offer surgery nor specific medical advice any longer. As in a museum, there is much to learn here from what I have done, my techniques and sculpture. You can browse answers on this forum to see the nature of this continued passion. You are welcome to join the forum or just browse and use our resources here. Part of the goal here is to continue the process of evolving surgery methods, documentation, and tool like How To Pick a Gynecomastia Surgeon.

If posting images here, learn about my Standard Gynecomastia Pictures a more critical documentation system that couples with Standard Male Chest Movies better reveal problems, solutions, and paths patients take to get there.

Hope this helps,

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

35
This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

Learn about Dermatography Explore our new Dermatoscope Store. Skin microscopes help define pigmented lesions and document details to track changes. Browse extended collection of reviews and learn about different scopes, light sources, and find books / references to learn.

I integrated dermal skin magnification into my clinical exam of pigmented lesions to optimize what to biopsy vs just observe. It was a powerful tool. Some of today's models offer polarization and no oil interface. Others make it easy for photo documentation with attachments to computer or even iPhone. Wireless connectivity for electronic medical records facilitate compulsive documentation and following lesions of concern. Here is a sample of the selection discussed:



Hope this helps,

Michael Bermant, MD
Retired Plastic Surgeon
Learn More About Reconstructive Plastic Surgery

36
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Second Opinion

Hello Dr Bermant,

I hope you don't mind me contacting you out of the blue like this, I realise you must get a lot of emails with questions but I have seen posts of yours on online forums which shows an admirable willingness to take questions from people. On that basis,  I was wondering if I could get a quick opinion from you on something?

My name is -, I am 26 and I live in London, England. In four weeks time I am due to go for gynecomastia surgery that will require some skin removal to prevent sagging, as recommend by my surgeon, Dr.-.

For minimal scarring, he also said he would use the Mastoplexy method, which will remove the 'donut' of skin, which will then be covered by pulling skin over. He will then be using Permanent gore-tex sutures underneath to keep it all together, and I believe this also prevents the areola from becoming stretched.

I have asked him the following questions and he seems confident that there will be no problem, but nonetheless I feel a bit daunted by having under-skin stitches for life and was wondering if you had any knowledge on this.

The main concern (other than the very small chance of infection) is the strength of these stitches. Will I be walking on eggshells the rest of my life, or will they be able to tough out every day activities (after a good period of healing and being careful of course).

Would I be able to exercise with jogging and weights (chest muscles) a few months later or are the stitches liable to snap. If someone were to push me in the chest, would they break or shift easily?

I understand these things are down to the skill of the surgeon, and some other variable factors but assuming he is skilled and there are no complications, would permanent sutures be tough enough to last through the years and the stress?

I really would appreciate anything you have to say on this.

All the best, and thank you.

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon. Sorry, I no longer offer email or private message responses, nor second opinions. I do try to share my knowledge here in this forum.

Excess Skin of the Male Chest with Gynecomastia comes in various degrees.  Management depends on many different factors. I preferred techniques avoiding the skin reduction whenever possible, but this depended on the amount of loose skin involved. Judging the amount of excess skin and effectiveness of the surgery requires critical documentation. That is why I evolved my Standard Pictures for Evaluating Extra Skin on the Male Chest. If a doctor is only showing results of patients standing upright, then there little to go by to validate the problems worked on,  their judgement, or skills. Standard Videos Male Chest are even more critical of how tissues move. We have tools here on How to Pick Your Gynecomastia Surgeon. The difference here, is that the problem is a loose skin issue and the pictures evaluating the technique should demonstrate just how effective that method is in real life. Seeing photos of someone standing upright just tells part of the story. Unless you can see what the tissues look like with the individual bending over or with arms up overhead, you are not really seeing what the body looks like in real life.

For some patients, my small incision skin reduction chest lift was necessary. This eliminates the unnatural very obvious unnatural vertical scar.  For smaller problems, I evolved my Internal Lift Male Mastopexy Surgery that has even smaller scars.  My internal lift is not suitable when the excess skin is a major contributing factor for the deformity.  A Male Donut Mastopexy when pushed too far will leave a star burst deformity that detracts from the result. That is why picking your surgeon carefully can be so important.

Choice of suture for the donut mastopexy is critical. Wrong material and wrinkling or worse Large Nipple Areola Complication from Bad Gynecomastia Surgery. It is a function of not just the suture, but the design of the surgery based on the problem, and where the suture is placed, size of suture, and many other factors. Again why seeing examples of the surgeon's work in motion critical to judge just what is being offered. Long term results are hard to get. There is so much Emotion Living with Gynecomastia that most move on with their lives not wanting to be reminded about their problems for long term follow up photos or Male Nipple Measurement Exam. When I had to do a skin reduction, each patient was cautioned that suture breakage was a risk. But again, that is why I evolved methods not to need to do skin reduction surgery yet still have good results and less long term risks potentially depending on non-regenerating materials like suture.

So questions best managed by the operating doctor based on their knowledge, plans, and experience. When skin reduction done when not needed and ending up with a disaster like I showed, that is really sad. But then why are not surgeons showing the degree of loose skin problem and success of tightening with better documentation like I evolved?

Why not post a complete Standard Set of photos and compare them to the various degrees of non skin reduction surgery success I had with my techniques using our extensive Before After Gynecomastia Gallery A good surgeon should be able to manage a large male breast reduction without the skin reduction unless there were significant weight loss lost skin elasticity. How much weight was lost? What was the change in the Body Fat Analysis or BMI? Have you reviewed before and after critical documentation of what the surgeon has done?

Hope this helps,

Michael Bermant, MD
Learn More About Male Mastopexy Chest Lift for Sagging Tissues

37
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Hi Dr. Bermant! My name is -  I read about you and I know that you are a retired Doctor but I was woundering if you can advise me or refer me to surgeon. My son was diagnosed with blepharophemosis since he was a baby. Now he will be 3 in march. Some of the Doctors told me that he may need surgery but we need to wait until he is 4 or 5 years old. I will aprecciate if you can help me find a great surgeon who does this type of surgeries on kids. I will really aprreciate your advise Doctor. Thank you very much .

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon. Sorry, I no longer offer private messages nor emails, but I do try to share my knowledge and experience here on the forums.

Blepharophimosis Syndrome includes Eyelid Ptosis drooping of the upper lid and a fold of skin that can obstruct vision. The problem comes in different degrees the severity can even vary from one side to the other. When the eyelids cover over the pupil blocking vision, early surgery can be critical in the brain's development to minimize the obstruction. When cosmetic issues become the major concern, timing of surgery sometimes is best delayed until a child can cooperate with the recovery and experience. Such issues are typically determined and discussed during an examination where Eyelid Function and vision function are assessed. Comfort and skill of the surgeon also can come into play with such surgery.

We have tools here on How To Pick A Plastic Surgeon as well as How to Evaluate Before and After Pictures. I have yet to add the specific eyelid documentation to those resources. Standard Eyelid Pictures in this case are not enough. There are the scar issues of the fold reconstruction details that would be nice to see close up photos. Actually, videos of eyelid function are better suited for this critical documentation.

Knowing more about vision function and skills and the in between the before and after photos would be of great value in better understanding a surgeon's skills and if the method of treatment was a good idea or fraught with difficulty getting there. Finding surgeons who put that type of detail on the web can be quite difficult. Yet that is how my practice evolved as I further specialized in different fields of surgery. Such documentation can be done and the public can be a help in moving medicine in that direction.

There is much emotion for both parents and children living with this condition. That is why I built this forum.

You are welcome to post your images or videos of eyelid function here in this forum so that others can understand your concerns. I hope to improve my standard views of eyelid pages I made so many years ago. Trying to establish documentation specific for Eyelid Ptosis is a way to monitor improvement after surgery. Posting problems here on this forum with more complete documentation can attract those with expertise to offer their opinions and views.  Links to resources they have built to explain their methods can be a powerful tool to prove a point.

Hope this helps,

Michael Bermant, MD
Learn More About Blepharoplasty Eyelid Surgery

38
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I saw Dr. Bermant about 4 yrs ago and he suggested a lose some weight and come back. Can you suggest some Dr. who can perform this surgery now that this office is now closed. Thank you for your assistance in this matter.
 
Very best regards,

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

It is not just a question as to who can do the surgery, but what are their results like for what problem.

When I was still in practice, Weight Loss Before Gynecomastia Surgery was the best sculpture I was able to offer.

You ask a common question, here are some similar requests:

Gynecomastia & Weight Forum - Compromise What Are the Options Who to Go To?

Fat - Gynecomastia Forum - Options For Surgery, Weight Loss, & Your Retirement

Gynecomastia & Fat Forum - Obese, Don't Care About Belly Can Surgery Fix Breast?

I still feel strongly that Weight Loss Forum - Gynecomastia Surgery not alternative to Losing Weight.

How To Pick Surgeon
Since retirement, I no longer offer specific medical advice but still share my knowledge about general issues and have been evolving tools like How to Pick Your Gynecomastia Surgeon. These critical tools of problem and solution analysis are what I used to evolve my technique over the years. My methods kept changing as I found better ways. These tools can also be applied to better understanding options like claims of compromise gynecomastia surgery effectiveness (if muscle building, loose skin issues and other factors are also documented.) That specific resource is an extension to How To Pick a Plastic Surgeon. I just revised that page so that it can be better seen by those with smartphones, tablets, or computers. We also have How to Pick a Plastic Surgeon Forum for basic discussions about the process of finding doctors in this age of marketing hype and finding the reality beyond advertising hype.

Forum as Tool To Learn and Find Other Surgeons' Skills
Another option is to use this forum to post problems and share concerns, what weight loss has done or what has not been done. Pictures best suited for someone who had or currently has weight issues would be Standard Pictures for Male Breasts and Loose Skin or Weight Loss Issues which I evolved for my Male Mastopexy Patients to best understand how well skin adjusted with the weight loss.

As long as some hide bad results behind limited photos, the public will be gambling what they may be getting. Here is one example showing Static Pictures Can Hide Deformity Seen in Real Life, Flexing, and Moving Muscles. . I preferred having a more complete understanding of the problem, defining it, and then documenting my solution. We live our lives moving actively, not with our hands down at our sides not flexing. For loose skin issues, not showing how it looks bending over, hides that contour component. For the compromise surgery choice, seeing the whole body, sides, and around the back would reveal how the global problem was addressed or managed. Just seeing the front does not work when going out on the beach when the whole body is exposed.

The forum is for others to share their new methods or ways to manage weight issues and gynecomastia. The challenge is to get beyond limited documentation of the problem and what any particular method or surgeon really offers. And that is part of the problem. Who else is putting up the whole picture? Without that detail, patients are gambling what results will be like. What progress was made?  What does it look like bending over? Is there a continued global fat contour component or is there now a loose skin problem? What compromises are satisfactory? Some are looking for motivation tools to continue their own body shaping with further weight loss. Others will accept the limitations of compromise surgery. I have set up a place where people can take charge themselves to explore problems and share experiences as to what works and does not.

You are welcome to join the forum to participate, use our resources, but retired, I am limited to my general sharing of my experiences and knowledge as I have given in this post.

Hope this helps,

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

39
This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

How To Evaluate Before and After Pictures is region dependent. Just what should comprise a standard set of hand pictures? This depends on the problem being documented, but should include both views showing the hand from multiple positions and function. Videos are a much more critical method to demonstrate hand problems and function revealing so much more than photos alone.

While the limited views shown in this Snowblower Hand Injury show a little, they were not the complete set taken. But at the date I was doing hand, my photos were slides, before the digital revolution. So it will mean going back to the slide collections and converting sets I took then to demonstrate the views I was doing way back then vs. what I have learned over the years about the power of dynamic documentation and the power of video. Vascular video hand exams are powerful statements that are so difficult to show with still photos.

Hand Standard Pictures
Whole hand with fingers in relaxed extended position.
Palmer View
Dorsal View
Radial View
Ulnar View

Whole hand with fingers fully extended position finders adducted
Palmer View
Dorsal View

Whole hand with fingers fully extended position finders abducted
Palmer View
Dorsal View

Whole hand with fingers flexed into fist.
Palmer View
Dorsal View
Radial View
Ulnar View

Whole hand with thumb to each of fingers (one photo for each finger)
Palmer View

Close up of lesion, wound details.

Vascular sensation issues additional.

Wrist Standard Pictures Would be additional

Basic Hand Video Ballet:
Palmer, then Dorsal, then Radial, and Ulnar views.
Start with hand with fingers extended relaxed in natural curve.
Hyper extend all fingers and leave extended to watch for vascular changes.
Relax hand
Flex fingers into fist.
Extend one finger at a time until all fingers extended. Then flex one finger at a time until all flexed.
Hand fully extended fingers together. Abduct and then adduct fingers and thumb.
Thumb to finger sequentially and then repeat.
Video also can then demonstrate specific hand function issues of concern, problem, or progress.

Hope this helps,

Michael Bermant, MD
Retired Plastic Surgeon
Learn More About Reconstructive Plastic Surgery

40
I saw a post on Facebook where someone is fighting their insurance company to get surgery for their

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Please help this is my last option cannot take this pain anymore I even included a picture from 20 years ago Can you please share I battled my insurance company bluecross and took them to the state commission of insurance and get screwed it proves if your not in the 1% no one cares all they said was we're sorry about your severe pain but we are not proactive please share this is my last hope

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My last option for surgery it's a donation site battled my insurance and took them to the state courts all they said was sorry but for the pain get pain pills eff that I'm not taking pills and with living with and helping my father who's on disability paying for surgery is a long stretch all I ask is for people to share .

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

Pain is Symptom of Gynecomastia, it is also a key Red Flag and something that is not treated either by surgery nor pain medications. Breast gland stimulation from unstable endocrine issues can cause swelling. This pressure translates into tenderness and discomfort. Neither surgery nor pain medications manage this underlying problem and why misadventures to manage individuals this way typically end in failure.

I worked with many Endocrinologists over the years to set up a better way to manage the problems of who should be seen by them before surgery. The goal was to minimize issues of Recurrence: Gynecomastia Revision Forum - Should Surgery Prevent Recurrence? Growing Again. We were concerned about unnecessary money being spent on stable situations. At the same time we wanted to lower the chance of recurrence since surgery does not stop breast growth. I was seeing too many failures and regrowth of breasts by patients with unstable gynecomastia operated by other surgeons. At the same time Endocrinology issues tend to be transient. The problems causing breast growth come and go, and once no longer present, discovering what might have been the cause typically an exercise in futility. This methodology of who should be sent to have evaluations evolved into my Gynecomastia Red Flag System. This method was received well during my invited Gynecomastia lecture at the American Association Of Clinical Endocrinologists 2008 national meeting.

Gynecomastia Tests. Such testing becomes critical for unstable gynecomastia or someone with Gynecomastia Symptoms such as current tenderness, breast growth, and or nipple discharge. Other gynecomastia testing, such as a Male Mammogram, I ordered when my clinical hands on examination finds something that I did not understand.

The main problem is Surgery Does Not Prevent Recurrence or Regrowth. The focus of that discussion was for breast regrowth. That regrowth typically had pain as a sign / symptom before the size increase. That discomfort is not just a gynecomastia issue, but a human mammal endocrine fact and seen in woman under the same hormonal stimulation and part of breast tenderness seen during periods and pregnancy.

Emotional Pain
Gynecomastia causes more than just physical pain. There is also Emotions Stress Living with Gynecomastia. That video is a great example of the issues of the contour problem.

Body Shaping Garments
Since I could not offer surgery to all patients, I evolved an alternate option for those who were waiting for endocrine issues to settle, be evaluated, or who needed to lose weight first. Body Shaping Garments is a series of before after photos of different body types and the compression garments ability to deal with the contour  component. The video is especially valuable for how tissues bounce. Patients with pain told me that stabilization of the tissues helped with the discomfort. Some with very tender breasts were not able to use the compression vests until the discomfort was less. Not all garments had the same ability to contour the chest nor offer the same comfort. I have yet to see any garment come close to what this Stage 2 Compression Vest offered.

Hope this helps,

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

41
Facebook Like Stuffing? Have you gotten an email asking:
Quote
Like -- on Facebook
Since you're already subscribed to their email updates off of Facebook, -- has suggested you like their Page to stay connected.
xx likes


This is a misrepresentation of reality. Does it meet the criteria of scam or fraud? I have received quite a few such emails and never once have I been "subscribed to their email updates off of Facebook" or anywhere else. I do not need to "Like" a page to "stay connected."

Why people click on the links assuming this to be the case boggles my mind. Why anyone would even send out such a request also bothers me. Facebook Like Stuffing for SEO search engine optimization is reality, but to stoop to unethical claims about subscriptions that do not exist is just wrong. Are such false claims enough to be an issue for societies with Ethics Bylaws? Do not know, but not as egregious a violation as those offering free services for Facebook likes, like I have seen. Internet marketing has deteriorated with some really bad things I have witnessed and do not like. The honest ethical doctor has been a key focus of medicine historically. Internet hype distortion of reality are a disservice to this key feature of medicine and should be dropped by those considering such tactics unless they prefer the snake oil charmer carney methods, that do not belong to real medicine.

I have been tempted to write a response on the walls of such pages, but did not want to take the risk of exposing the people or saying why I did not like the pages. I have typically just blocked the people as people I wanted nothing to do with until yesterday. I am still trying to decide to tell this individual what they are doing or not. I hope this is not a trend that propagates and degrades our profession with untruthful statements for marketing gains? How sad. I am retired and perhaps should not care what others do.

Here are some other discussions on Facebook Like Stuffing:

Facebook Likes: Please Like This Page for my Content & Efforts Plastic Surgery Education
I just saw another sad attempt at FB Like stuffing
. In that case someone was claiming I had liked their page when I had not. In that case, I had reviewed the page found many things I thought were violations of Code of Ethics that my Plastic Surgery Societies use to maintain appropriate ethical photographic documentation and other issues. I did not mind saying nothing, but when that individual phrased a response that could be interpreted as if I had supported such a page, made me angry enough to post that response and block the person's account.

Facebook Likes should be based on content, quality of services, results, performance, not marketing hype. That is why I build resources like How to Use Before After Pictures, a much better tool to see the skills of an artist are how they transform problems into solutions and how those solutions move and perform in real life. Here is another tool: How to Pick Your Plastic Surgeon.

Yet, I have seen some very inflated numbers on several empty pages with no content. in some cases I went further and looked at the before and after photos and myself would never let that person touch me as a surgeon from what I saw. Yet the Facebook Likes were high? So what are Facebook Likes good for? Not sure.

What are your thoughts? Are such actions OK? Should there be cult doctors of high Facebook Like counts?

Hope this helps,

Michael Bermant, MD
Retired Plastic Surgeon
Learn More About Plastic Surgery

42
Quote
As a Plastic Surgeon, where should I post answers to patient questions? I want to help others but prefer I get credit for work I perform helping others.



This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

Helping others is a powerful tool.  There are marketing companies preying on surgeons for content such as questions being answered, that the marketing company gets the credit, not the surgeon. Building an identity on the Internet can have great value. Having searches on the Internet go to the content you made is best when that content goes back to what you made. The page should show the surgeon as the author:Google Authorship

So how does one do both?

I started answering questions and putting them up on my web site. This took forms such as: Inverted Nipple Forum to posting my patients' experiences such as: Gynecomastia Experiences.

The organization of answers tends to be haphazard, and was organized by topic and then larger collections such as Bermant's Bulletin Boards and Plastic Surgery Discussion of Patient's Questions and Answers. . Finding the questions can be made easier using a local search engine for your site: Plastic Surgery Search Engine. Eventually common questions were better managed by pages such as: Liposuction Frequently Asked Questions. The answers were somewhat limited but organized.

That puts the content on your own site and credit for the answers is yours. However, you need the questions being asked, and then people need to be able to find your work online. I put the social networking tools on each page of my site, but still the site page needs to be found by the search engines, indexed, and then the public needs to be able find you.

I tried posting on other forums but found one problem or another with each forum to the point I eventually decided to make my own: A Body Beautiful Forum and you can see the entry page to posting here: Plastic Surgery Forums.

Each post could have links to my main content. I could leave my content on the original site, had a great set of social networking publishing tools, a good search engine to find the content, and I could link to any post I was making. I could make any board I wanted, and search engines were finding my content fast.

I then evolved a better form of Gynecomastia Frequently Asked Questions that incorporated my posts that linked back to my own content. Check out an example like the second from the first panel: Rate My Gynecomastia. Try doing something like that with content generated answering questions on the marketing sites, facebook, google+, LinkedIn, or almost anywhere else I have looked. I even found a way to get Google Authorship set up.

I was able to set the forums up such that the bottom navigation links to resources specific to the topic. Check out our Lower  Navigation Toolbar.

   Otoplasty Forums

   Tummy Tuck Forum

Interested in joining this effort? Let me know. Looking for others to help build sections with resources, not just to their own sites, but major resources of value on the Internet. Resources should be major in nature. Eventually advertising may be incorporated.

Hope this helps,

Michael Bermant, MD
Retired Plastic Surgeon
Learn More About Plastic Surgery

43
Quote
Hello,
 
I am - and I had done Otoplasty about 13 years ago. Unfortunately my ears were pined back to much towards my head, my right ear is more towards my head than the left ear.
I am looking to have a surgery revision to correct this mistake. Would like to know if this is posible to be done.
Please let me know if nay further information or pictures are need.
 
Respectfully,

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

There are many different problems that can result in

Correction depends on which element of Otoplasty Ear Anatomy was over corrected and what surgery was done to that anatomic part such as removal vs. over folding cartilage. Sometimes deformities like the Revise Over Folded Antihelix or a Concha Bowl Deformity can be improved / revised.

Options for Revision Otoplasty depend on the original problem, what was done, healing, and many other factors we used to evaluate during an in office consult or start with our Preliminary Remote Discussion.  Retired, that is no longer an option. Standard Otoplasty Pictures can be posted here for all to see, review, and discuss. Sorry, I no longer offer private discussion by email or messages. However, I do try to share my knowledge here in these forums.

I also used extensive otoplasty history forms which were a great way to insure all the needed details were there to learn about a patient's condition for revision ear surgery. Prior operative reports can be quite valuable in understanding what was done. That long since surgery can be a problem.

Revision Otoplasty surgery can be quite difficult and our resources on How to Choose An Otoplasty Surgeon, the pictures evaluated should specifically include how that surgeon manages revision Ear surgery.

Hope this helps,

Michael Bermant, MD
Retired Plastic Surgeon
Learn More About Otoplasty Ear Surgery

44
Quote
Hi

Wondering if you ever have any Gyno surgerys get cover by medical insurance. I have blue shield of California PPO.

I'm a 25 yo male generally healthy all the way around and I'm currently at 245lbs and 68" tall. I tried the weight loss and worked but the Gyno was still there.

Thanks for your time

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

I am sorry, but insurance payment decisions keep changing. I do not remember of any insurance surgery approved for someone with global fat problems. But as a surgical sculptor, I preferred to use the coarse tool of weight loss first and reserve surgery for refinement.

Check our BMI Calculator and put your numbers in it. BMI alone does not tell the entire picture for some with massive muscles. That is why understanding Body Fat is so critical and why we taught about Body Fat Analyzers as a great tool to understand about body composition. The newer models with wireless connection to the iPhone and other smartphones such as



Fitbit FB201W Aria Wi-fi Smart Scale



Withings Wifi Body Scale



and the new Withings Wireless WS-30 with its bluetooth -wifi and smart update advances.

We also have added a more expensive option:



Tanita BC-1000WH Ant+ Wireless Body Composition Bundle with Remote Display.

I like the connectivity and data collection power of a wi-fi  or bluetooth connected measurement tool for someone working on weight loss, bodybuilding, working out or any other system for body change. The concept of a more comprehensive proof for method working is important. Having the scale analyzer connected to your phone, computer, ipad or other device is great.

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.

Plastic Surgery is not an alternative to losing weight.  With surgery, an overweight person will still look like a overweight person, just one with smaller breasts and contour problems that continues around the chest, under the arms, and around the back.  Plastic Surgery is not a good tool for a global fat problem.

I used to advise my patients to get to a weight / body fat percentage they are comfortable with before considering surgery. 
 
Weight Loss Before Gynecomastia Surgery can help with the fat, but not the gland.  However, you cannot pick where your fat comes from. Plastic Surgery is also not a good jump start tool for weight loss.  I have seen disasters from patients from other doctors with deformities from significant weight loss after their surgery.  Men tend to put fat on first in the belly and chest bands.  We tend to take of those areas last.  Early surgery and depending on weight loss to predictably change the body is a nasty gamble.  No Surgery Body Shaping Garments are a better temporizing choice.

Weight Loss vs Gynecomastia Surgery Has Come Up Many Times in The Past:

Weight Loss Forum - Gynecomastia Surgery not alternative to Losing Weight

Male Mastopexy Chest Lift Forum - 100 pounds weight loss loose skin chest

Fat - Gynecomastia Forum - Options For Surgery, Weight Loss, & Your Retirement

There are many other examples, use our search tools to find more.

You are welcome to join our discussion group and post images.

Our Standard Stomach and Lower Body Pictures and Standard Chest Pictures are resources for the views that are good to document progress made with the weight loss on contour components and how skin is contracting.

Hope this helps,

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

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Hi Doc,

I don't want to waste your time but was hoping you could help me. I am an American living in Brazil. Long story but my son was born here in 2006 and due to unforseen circumstances I had to stay here to take care of him.

I just had surgery on December 17th. Gland and fat was removed. The right side right after the surgery was fine and still is. Left side developed a hematoma and I had to go back to the surgeon the same day for him to drain it. My chest was extremely swollen.

If you have a few minutes can  I send you photos for you to look at and just tell me your opinion on what I can expect. The left side has gotten better but is a far way from being normal.

Sorry to bother you since you have retired and I hope all is well for you.

Regards,

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

A Hematoma Complication of Gynecomastia Surgery is a collection of blood in tissues where it does not belong. Hematoma come if different sizes and progress depends on the cause, how much blood ended up in the tissues vs. how much was removed, the original problem for surgery, surgical techniques, skill of surgeon, how someone clears bruises, after surgery care, Gynecomastia Compression Garments, and many other factors.

Typical Bruising and Swelling After Gynecomastia Surgery for my patients can be seen in this photo gallery. Click on the individual photos to see more about each patient, degree of problem, how they moved, and results. However, this progression was typical for my patients. Most surgeons do not show the path taken between the before and afters. How patients evolve varies with different techniques.

I worked hard at minimizing trauma, bruising and swelling for my patients, but a hematoma is a real complication that I discussed before surgery. We worked hard at prevention and they were quite rare for my techniques. With hematoma, Healing and Recovery for that tissue can be be slower. Like firm gland, the firmer healing tissues can distort the male cut look. Blood not absorbed can lead to scar tissue that can also distort the male chest contour as is discussed in this post:

Gynecomastia Surgery Forum - Had Hematoma & at 3 Months Look Same As Before

Sorry, I no longer offer private review of photos. However, pictures can be posted here in this forum for all to see and discuss. My Standard Revision Gynecomastia Pictures were designed to reveal critical details of such problems. The complete set are much better to document the problem, evolution of tissues, and how tissues move than just one or two views. Gynecomastia Movies are even more revealing of these problems. Posting before pictures, what was done and what happened also can help define matters.

For my patients, Second Stage Male Chest Compression Garments and Scar Care were critical pillars in long term treatment to optimize scars and help how tissues move after surgery. I preferred to individualize timing and method of care for each of my patients.

Hope this helps,

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

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