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*** How To Choose A Gynecomastia Plastic Surgeon ***

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DrBermant

*** How To Choose A Gynecomastia Plastic Surgeon ***
« on: December 28, 2008, 11:35:45 AM »
I see Dr. Bermant all over this board. I think it's great that he is in this struggle with us. Has anyone actually used him on this board?
I live in Nashville TN, how can I find a proven doctor that can sculpt my chest. Does any have any doctors in Nashville they can recommend?
I'm so totally not satisfied with my first doctor, I had no idea that when he was finished my chest would be the same size 3 months later.
I'm even considering traveling to Virginia just because it looks like Dr. Bermant actually knows what he's talking about.
Help me out guys, what should I do...

This is a valid question and there is no one factor that is an answer.

Board Certification in Plastic Surgery Anyone can call themselves a plastic surgeon or cosmetic surgeon.  There are major requirements for those to become Board Certified in Plastic Surgery.  Some of the worst complications I have seen for male chest contouring have been from General Surgeons, Dermatologists, Urologists, Gynecologists, and those with no boards at all attempting such surgery.  You can find out what if any board certification a doctor has here:

http://www.abms.org/

Years ago, Merle made it a policy to only permit Board Certified Plastic Surgeons participate on this forum.  You can search the ABPS database

http://www.abplsurg.org/

for a local plastic surgeon, however not all surgeons have the same skills nor use the same techniques.  Around the world there are other Plastic Surgeon Boards.

Plastic Surgery Society Memberships is another criteria.  Surgeons, their work, advertisements, and websites are examined to be admitted to recognized Plastic Surgery Societies.  The American Society of Plastic Surgeons is the biggest and also has a directory to search.  For an additional fee a member surgeon can also post a web page describing themselves and what they specialize in.  The American Society for Aesthetic Plastic Surgery is a society of those surgeons who specialize in Cosmetic Surgery.  A member surgeon can pay to have their listing enhanced in their search database.  There are other recognized societies out there, many of them with rigorous criteria for membership.  However, there are also many societies that have much more lax criteria that permits less qualified members.  Trying to discover just what those criteria can be confusing at best.

You can also look into what a doctor has done as far as malpractice claims and actions by his state medical boards.  I like using Doctor's Disciplinary Information Search from The Castle Connolly site.  This works for doctors licensed here in the United States and may not have all the details needed to understand the issues.

Doctor's Awards can be another issue.  Some are non-restrictive that when you put almost any doctor's name in the query box, he or she has "won" that award.  Others are much more difficult to achieve and can only be voted on or awarded by their peers.  I am very proud of the Top Doctor's in America award by Castle Connolly that I have won now 7 years in a row.  As of the 2007 guide (2008 is yet to be published), there are only 150 Plastic Surgeons listed in the current directory and only 3 in Virginia.  It is important to check out the criteria for any such award, how doctors are selected, and are they still recognized for that achievement.  That award spells it right out on the site for all to see.

Other awards are less clear.  I am even more proud of a Distinguished Service Award given by my own peers, Plastic Surgeons.  That particular award published by the American Society of Plastic Surgeons is listed in the yearly Members Roster Directory and in the Annual Meeting Publication.  Through my career I had found the names on that list of surgeons I had respected, admired, and emulated from when I was early in training.  To end up on that list myself still overwhelms me.  Yet that award and its description is not listed for the public.  You need to be a Plastic Surgery member to even get to that list on their website. 

Before and after surgery examples:  Photographs can be a valuable tool to see what a doctor has done.  However, a single view before / after does not really tell the story.  What can look good / bad from one angle may look different from another.  Better doctors are able to show examples of their work.  I am suspicious when there is only a single view or just a few of the best for each patient (even more so when the view shown changes from one patient to the next).  The quality of the before / after images can also be a factor.  Different framing, background colors, photographic techniques, lighting, can be deceptive. 

Reading patient posts in forums can be valuable.  However, not all posters show before / after images and what one person considers "great" might be much less acceptable to others.   Numbers of posters about a surgeon may be a factor.  However, the vast majority of my patients do not post here.

Reading patient posts on doctor's websites can also help.  Anything a Plastic Surgeon who is a member of the the American plastic surgery societies, is required to be held to a high code of ethics that prohibits false claims or deceptive advertising.  The doctors can be held to what is on their own websites.  However, what is posted on forums by "patients" is much harder to control.

The American Society of Plastic Surgeons ethics committee have just proposed amending the criteria to prohibit lower surgical fees for patients helping with advertising: That a false, fraudulent, deceptive or misleading statement or claim includes a statement or claim which:  “Contains a testimonial or endorsement pertaining to the quality of the member’s medical care or the member’s qualifications if the endorser has been compensated by the member or a third party retained by the member for making such testimonial or endorsement.”

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

Linkback: https://www.gynecomastia.org/smf/index.php?topic=16474.0

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DrBermant

Re: *** How To Choose A Gynecomastia Plastic Surgeon ***
« Reply #1 on: February 06, 2009, 06:58:00 AM »
The 2008 Castle Connolly Top Doctors of America has finally been published.  You can follow that link to learn how doctors are selected for this achievement.

Plastic Surgeons: There are currently only 163 Plastic Surgeon in the entire United States so selected.  (For all years, the total number of plastic surgeons is 613, some were included for some years and not others). 

Virginia: The total for 2008 for Virginia Plastic Surgeons is 3 (9 all years included). 

Gynecomastia: Gynecomastia again I am the only one included in the current guide.  Over all of the years, a total of 4 surgeons have been listed.

I also find the guide useful for searching for other specialists who are tops in their fields, such as Endocrinologists.  However, their free search is limited to a subset of their total doctor listing.

http://www.castleconnolly.com/doctors/index.cfm?source=ccm

I am proud and humbled to be again included in this guide to the Top Doctors in American Medicine.

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DrBermant

Re: *** How To Choose A Gynecomastia Plastic Surgeon ***
« Reply #2 on: December 27, 2009, 01:21:44 PM »
In reading posts here on the forum, I find that several points mentioned above should be emphasized. Homework about a doctor is critical. When researching a doctor, look for

Malpractice Cases, if any, and for what?
License Restrictions some doctors people are asking about in this forum have had major sanctions for practicing bad medicine.
Medical Training I have no idea why a patient would trust a male chest sculpture to a doctor trained as a Radiologist, Ears Nose and Throat, or no training at all!
Board Certification Is a gold standard. When a doctor declares their own specializing without any such board or training, it is a formula for disaster.

Such details can be found on their state license or professional conduct sites on the internet. Failing to evaluate such issues can lead to a disastrous choice in doctors.

Then there is the evaluating a doctors before and after pictures. Choosing an artist without seeing their work is another mistake. Carefully looking at what is on their sites, here on this forum, and elsewhere can give a clue to the caliber of their work. Do not assume any doctor's results look like any other.  This is an art form and proof is in the work itself. I see on this forum posters recommending "their doctor" with results that have crater deformities, poor scars, and bad contour results. Some of these recommendations have doctors posting on their websites results that are just terrible. I have had many patients coming to me for revisions with deformities as bad as some of the "good results" posted by a doctor's website. I take pride in my patients telling me that their results look as good or better than what they saw on my website.  You should be able to ask a doctor if the results on their site or what they show in their office are typical for them.

Patient Education Look for a doctor with a complete package. When someone on this site recommends a doctor, look at that persons other posts. Evaluate their need to ask questions here instead of what their doctor educated them about. I have always wondered, if a poster's doctor was so great, why were they on this site asking for help after surgery?  Patient education is an important component of a successful result. I consider my efforts effective when few questions come from my patients here.

Travel, Cost, and Saving Money How often does that doctor's patients need revision. Revision Gynecomastia Surgery can be much more expensive than doing it right the first time.  Travel and a possibly higher initial price may be a major cost savings than needing to take time off for a second surgery.

Experience With Specific Problem I work with up to 8 gynecomastia patients a day. Some see much less. Gynecomastia comes in many different forms. Experience evolves over time with any surgeon. Check to find examples of that surgeon's work for that specific problem. Do not assume that just because the surgeon can do one type of sculpture, they are proficient is all.


Hope this helps,

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


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DrBermant

Re: *** How To Choose A Gynecomastia Plastic Surgeon ***
« Reply #3 on: January 26, 2010, 09:42:34 AM »
The new Castle Connolly Top Doctors in America just went active online for 2010 and the 9th edition of the guide.

http://www.castleconnolly.com/doctors/full.cfm?doctorid=20CC000000

Those doctors listed in the current guide have a star by their names.

Plastic Surgeons: There are currently only 191 Plastic Surgeon in the entire United States so selected.  (For all years, the total number of plastic surgeons is 624, some were included for some years and not others). 

Virginia: The total for 2009 for Virginia Plastic Surgeons is 3 (9 all years included). 

Gynecomastia: Gynecomastia again I am the only one included in the current guide for Top Doctors in America.  Over all of the years, a total of 4 surgeons have been listed and now there is an endocrinologist who specializes in Gynecomastia.

I also find the guide useful for searching for other specialists who are tops in their fields, such as Endocrinologists.  However, their free search is limited to a subset of their total doctor listing.

http://www.castleconnolly.com/doctors/index.cfm?source=ccm

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia Surgery

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DrBermant

Re: *** How To Choose A Gynecomastia Plastic Surgeon ***
« Reply #4 on: March 10, 2010, 11:33:21 PM »
Before and After Pictures
Be careful of a surgeon with only a limited number of before and after surgery pictures to show what their work is like. The camera angle and framing of the picture should be the same for each comparative view. When the size of sites outside what was operated on, like the shoulders, then a valid comparison is not there. A complete set of angles is critical to evaluate results. I prefer my Standard Sets to emphasize different issues for the various problems of gynecomastia:


Each set shows critical issues such as animation, how tissues move, how they look with arms up over the head (you want your chest to still look natural when playing volleyball or basketball. The multiple angles show critical issues of the surgical sculpture that can easily be covered up when only a few limited views are shown.

Look at the before and after images. Is the after surgery curve male looking or are there residual female like curves?  Is the surgery itself a compromise such as contouring an overweight individual. Surgery does not make someone with global body fat not look like they have global body fat. Where are the scars? Are there enlarged images showing the scars?  It would be most suspicious when a site only lists a few views and those views change from patient to patient. That is one way to hide the nature of the results or show the best view. The more inclusive set of images is a more consistent critical analysis of the quality of the sculpture. Even better are there early after surgery images?  What does the tissue look like during its evolution after surgery? Many will only show long term results, not how the tissue got there. If something looks good early on, shortly after surgery, longer after surgery, and long term that has advantages over extended swelling and bruising. How uncomfortable was the patient after surgery? Videos of patients talking about the surgery are one way to learn about this, their emotion behind the words has a great deal of power in understanding the nature of what a patient needs to go through to get to the end point.

Hope this helps,

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


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