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moving arms over head/flexing , does your technique provide a natural look?

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do any of you doctors pay attention to  how results look when flexing and moving arms over head?
if I understand Bermants technique correctly, he is able to remove virtually ALL of the gland because he removes it first and then fills the hole with fatflaps.

Ive read how most of you other doctors do it on this board, and you do the lipo FIRST to dig a hole for the gland and then leave some of it to prevent cratering, which does not look good when moving arms/flexing since remaining gland does not compress like fat (according to dr bermant)
is he correct?  he has said that during career he has never created any craters

do you have photos or videos to prove that your technique looks just as good as bermant when moving arms over head/flexing?
I would love to see them, and I am sure many others would before deciding which surgeon to choose

Linkback: https://www.gynecomastia.org/smf/index.php?topic=23898.0

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DrBermant

do any of you doctors pay attention to  how results look when flexing and moving arms over head?
if I understand Bermants technique correctly, he is able to remove virtually ALL of the gland because he removes it first and then fills the hole with fatflaps.

Ive read how most of you other doctors do it on this board, and you do the lipo FIRST to dig a hole for the gland and then leave some of it to prevent cratering, which does not look good when moving arms/flexing since remaining gland does not compress like fat (according to dr bermant)
is he correct?  he has said that during career he has never created any craters

do you have photos or videos to prove that your technique looks just as good as bermant when moving arms over head/flexing?
I would love to see them, and I am sure many others would before deciding which surgeon to choose

Although I target the gland first I have never said that I am "able to remove virtually ALL of the gland." The quote I have used here on this forum for many years has been that fingers of gland spread through fingers of fat. I have been honored that other surgeons have taken up that demonstration phrase posted here for so many years and shown in my office as I put the my fingers of one hand in between the fingers of my other hand to demonstrate what I have been finding in the operating room. Because of this natural anatomy, which I demonstrated with my own drawings of this relationship on my website, it is virtually impossible to remove all of the gland. The quote continues: shreds of gland remain behind with any surgery technique, even radical mastectomy for cancer.

The issue of any concept however, is the proof. I have seen too many patients unhappy after surgery done elsewhere. They were complaining that at rest the results looked O.K. but they did not live their lives with arms at the sides. They were embarrassed by the deformities I have demonstrated only a small number of those I have seen on my website. That is how I first started developing a system for documenting deformity and solutions on the male chest with my Standard Pictures and then even more critically with the Standard Videos. If something works, it should work beyond just verbal hand waving. It should be able to look good living life, playing sports, swimming, and other activities with shirt off. I have been told by quite a few patients that, when they went back to their original surgeon, the patient claims that the surgeon refused to take pictures with arms up overhead or flexing muscles.

The most fascinating issue about this documentation, is that they have been a work in progress for many years as I found better ways to demonstrate issues that patients were asking for my help. I have been learning from my patients over the years and adapting from their stories and details to improve myself.

I have no knowledge of any craters from any of my primary gynecomastia surgery. Unfortunately with a practice seeing patients from around the world, it is not realistic asking each patient to return just for pictures. I have had revision surgery cases that I was working on terrible deformities that resulted in residual contour issues. The goal for a compromise case like that is improvement and I demonstrate such typical limitations on examples on my site.

Hope this helps,

Michael Bermant, M.D.

thanks Bermant, your results photos/videos really speaks for themselves.

what about you other surgeons, any comments on this matter?


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