How to Choose a Gynecomastia Surgeon
How do I choose the right surgeon for me?
With Plastic Surgery, the answer may be easier than you think.
The task of finding a competent cosmetic surgeon to successfully treat your gynecomastia can at first seem quite a challenge to say the least.
Perform a Google search in your area and you are inundated with innumerable choices of cosmetic and plastic surgeons. Many will claim to be an ‘experts’ in the treatment of male breast reduction, gynecomastia or ‘puffy nipples’. Many will have impressive web sites showing tanned male models with perfect muscular chests or assorted videos verifying their expertise. However, it is important for you to find a surgeon who not only performs gynecomastia surgery regularly, but also one who consistently obtains great results.
The Art of the Decision: The following tips offer an orderly, thoughtful and straight-forward approach to help pick the right surgeon to perform your gynecomastia procedure.
1. Board Certification
Bottom Line: Make sure they are certified by the American Board of Plastic Surgery
Details: Board certification by the American Board of Plastic Surgery is considered the “Gold Standard” with regard to credentials in plastic and cosmetic surgery, and is the only board certification that is recognized by the American Board of Medical Specialties, with regard to the specialty of Cosmetic Surgery of the Breast Body and Face.
2. Before and After Photos
Bottom Line: One of the best ways to help predict what type of result you will receive with any particular surgeon is to view lots of his/her before and after photos.
1. Have the surgeon demonstrate their previous results through before and after photos.
2. A surgeon’s experience with gynecomastia surgery is frequently proportionate to the size of their website photo gallery or in-office before and after photos.
3. When viewing before and after photos, assume that the results being shown represent the surgeon’s best work, because it most likely does.
4. Don’t count on your result being any better than the best results shown to you by any particular surgeon.
5. Remember, seeing great results of before and after photos for a particular surgeon is usually more important than the particular surgical technique they profess to use.
How many before and after photos should I see from each surgeon?
Bottom Line: The more photos the better!
Details: You can never see too many photos when evaluating a gynecomastia surgeon’s work. This may seem like a lot to ask of the doctor, but if they frequently perform gynecomastia surgery and get great results, they most likely will have plenty of before and after photos to show you. Look for consistently excellent results that would satisfy you if it was your result.
Inconsistent results or a small number of cases should serve as a red flag regarding that surgeon’s experience and/or quality of their work.
What do I look for when looking at a doctor’s before and after photos?
Bottom Line: Expect a normal looking chest in the “After” photos with reasonable symmetry and round areolas with no signs of scarring or contour irregularities.
1. When viewing the gallery, ask yourself, “Would I want to look like the ‘After’ photo? Would I be happy if that were me? The more times you find yourself answering no, the less likely you will be happy with that surgeon’s work.
2. Carefully look for the degree of symmetry, as well as visibility and quality of the scars, particularly around or inside the pigmented skin of the areola.
3. Excellent gynecomastia results can only be confirmed by close-up views of the areola.
4. In most cases of straightforward gynecomastia surgery, scars visible from conversation distance should be avoidable.
5. Visible indentations should serve as a red flag regarding that particular surgeon’s technique.
6. Are the areolas oval or irregularly shaped? They should be round and completely normal appearing.
7. Is it obvious from the ‘After’ photo that the patient has had surgery? If you are looking for a ‘natural’ appearance from your surgery, you probably would not be happy with that quality of a result.
What details should I look for?
- Indentations and contour irregularities and of the chest and areola
- Clamshell Deformity — lower half of the areola is flattened and often indented
- Oval shaped areolas.
- Generalized distortion, unnatural visible scars
- Raised, easily seen scars
- Significant asymmetry in the amount of reduction performed
- Incomplete Removal of Diffuse Fatty Breast Tissue
- Failure to Correct the ‘Puffy Nipples
Whenever possible, magnify the images on a surgeon’s website in order to spot some of these problems, since they can be easily missed on cursory examination.
Should I assume that the photos I am being shown by a surgeon are his/her own work?
1. Always ask if the doctor seeing you operated on all of the patients that you are shown.
2. Sometimes, especially in group practices, the photos shown to you might be patients operated on by another surgeon in the group.
3. Ideally, you would like to see uniformity of the backgrounds and lighting used in the photos, with consistent technique and poses
4. Do not accept photos that have obviously been copied out of a book, these usually are very grainy and dark appearing, and are easy to spot if you are looking for them.
STOP HERE AND EVALUATE
1. Is the surgeon Certified by the American Board of Plastic Surgery?
❐ Pass ❐ Fail
BEFORE AND AFTER PHOTOS
1. Were you shown enough excellent results?
❐ Pass ❐ Fail
2. Did you verify that the surgeon performed all of the surgeries viewed?
❐ Pass ❐ Fail
3. Would you be happy with having 9 out of 10 of the results you were shown?
❐ Pass ❐ Fail
4. Did you see any indentations, contour irregularities, oddly shaped areolas, poor scars or unnatural symmetry?
❐ Pass ❐ Fail
If the surgeon does not pass the first 2 criteria, you probably have a better chance getting an excellent gynecomastia surgery result with another more experienced doctor.
If this is the case, you owe it to yourself to keep looking, even if it means traveling. Remember, it’s always better to travel afar for the first surgery, than for the second.
Ideally you only want to have your surgery performed once, since re-do gynecomastia surgery is much less likely to produce an excellent result than the first time around.
Other Important Factors to Consider
Obviously, there are many other factors that go into making a good decision when picking a surgeon to treat your gynecomastia, including:
Hospital Privileges to Perform Gynecomastia Surgery
Even if your surgery is to be done in an office surgery center, does the surgeon you are evaluating have hospital privileges to perform cosmetic surgical procedures such as liposuction and gynecomastia surgery? This is one of the best ways to check on your doctor’s credentials. Hospitals will typically only grant privileges for a particular procedure to those with the proper formal training and credentials to perform it safely.
Find out what portion of the surgeon’s practice involves the treatment of male breast enlargement. Ideally, you would like to hear that they perform this type of surgery on a weekly basis, rather than just a handful of times per year. The number of gynecomastia before and after photos a surgeon displays in their office or on their website is often a direct reflection of their experience with the procedure.
Although you may not know as much as the surgeon, with some simple research prior to your consult, you should be able to follow what the surgeon is saying and have it make sense
1. Is their recommended procedure custom for you?
2. Does the technique address all of your issues? For example: Loose skin, the crease beneath your breast, puffy/enlarged nipples or diffuse enlargement.
3. The surgeon should be able to give a simple, uncomplicated explanation as to how and why they recommend a particular technique for your particular body type.
Reviews from previous gynecomastia patients should be consistently excellent.
Be critical about the reviews you read. For example, a 5 out of 5-star review saying that “the office staff was great” is nice, but will not necessarily help you in finding the right male breast reduction surgeon.
Seeing excellent before and after photos of procedures other than gynecomastia surgery can be helpful, but is not necessarily predictive of what type of gynecomastia result you can expect from that particular surgeon.
Perform an online credential check with your state’s department of health regarding your surgeon’s license status and possible previous disciplinary actions. A call to your County Clerk’s office can often reveal whether or not your surgeon has a history of multiple malpractice judgements against them.
Surgical Facility Evaluation
Type of Facility: Male breast reduction surgery is typically performed on an outpatient basis, and it is perfectly fine to have it performed in an accredited ambulatory surgery center in patients without serious health issues.
Accreditation: If the surgeon that you are considering performs surgery in an office surgery center, make sure that the facility is accredited by at least one of the major accrediting agencies and that it is up to date with regard to certification.
Medicare Accreditation & Certification is the ‘Gold Standard’, and signifies that the surgery center is ‘hospital grade’ with regard to its safety requirements, policies and procedures. For more information on accreditation, click here.
Take your time in seeking out the gynecomastia surgeon that fits your needs. It may be the first doctor that you see in consultation. However, if not, be patient and don’t feel pressured into going with a surgeon that you have trouble connecting with or who has minimal experience.
After you have done your homework and narrowed your choice down to a few surgeons that meet the basic minimum criteria discussed above, trust your intuition and go with the doctor that you feel is seriously interested in helping you achieve your surgical goals and will take excellent care of you throughout the entire course of your treatment.