Caveat Emptor!

Gynecomastia If you watch any television, I’m sure you’ve seen those car insurance commercials where the inadequately insured speaker argues that he didn’t buy the wrong insurance policy—he had the wrong insurance company. Well, that can apply to many of life’s purchases, including cosmetic surgical services. This was recently the case of a patient in my office, who had undergone a liposuction procedure to address his gynecomastia, which had resulted from use of a pro-hormone testosterone booster.

The practitioner who did the procedure is not trained as a plastic surgeon, but he aggressively advertises his liposuction services for treatment of gynecomastia in a variety of media around the Boston area. Since he is advertising his “expertise” for gynecomastia, prospective patients are likely to be drawn to his practice when doing their research, and if they get as far as requesting a price quote, they’ll discover that he charges about half of what I and other plastic surgeons in the Boston area charge for comprehensive treatment of gynecomastia.

Unfortunately, he may or may not tell them that he only uses liposuction, and he does not excise the sub-areolar “gland,” a problem that is common in most patients but most certainly in those patients with a history of hormonal stimulation as the cause of their gynecomastia. The result in this patient looks similar to many of my leaner pre-operative patients, with an obvious mass in the nipple-areolar region on both sides.

As nearly a year has passed since the surgery, the patient had asked on several occasions about management of the residual deformity, only to be told by the “surgeon” that the result was okay with no further treatment planned—or available! At this point, the patient has consulted with me to address the problem, and unfortunately for him, he’s out the cost of the original procedure and facing a complete revision. Fortunately for him, his results can be corrected fairly simply with additional suction and excision of the “gland” on each side to give him a more fitting result. Conditions, such as gynecomastia, which are often embarrassing to those suffering from them, are generally managed quietly without much sharing of the experience.

As a result, it’s difficult for a guy to ask his friends about their experience with treatment, since most men don’t share information about their condition. Nonetheless, thorough research is required before embarking on any surgical procedure, especially those deemed “cosmetic.” Self-pay procedures are appealing in this era of health insurance challenges, so entrepreneurial practitioners may pursue these patients, even if they’re not necessarily the best person to provide that care. Internet marketing now allows for such practitioners to pay their way to first page listings, and there are many ways that individuals can make themselves appear more qualified than they are. The burden is on the patient to filter out which surgeons are most qualified and which are to be avoided.

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