A Moment with...Dr. David Berman

Dr. David Berman has one of the easiest, friendliest manners you will ever come across in a plastic surgeon. He has a way of immediately making you feel comfortable like you've lived down the street from him for years. He is best known as the surgeon who helped John Wayne Bobbitt through a certain well-known trauma. Dr. Berman has performed hundreds of breast augmentations in his twelve years of private practice and his schedule gets busier with each passing month. A great sense of humor and an obvious love for his craft come through in the following exchange.

BI411: What originally interested you in plastic surgery?

Dr. Berman: Plastic surgery is fascinating, because it's an interesting mix of following basic principals and then using your own individual techniques and ideas; mixing hard science and artistry. It's ironic; my wife is very artistic and I can't paint or draw, but she says "You're essentially doing the same thing, you're just using people".

BI411: What should a woman expect from her first consultation with you?

Dr. Berman: My first consults are actually very extensive. I'll ask them initial questions about their health and any particular medical problems they have and then I'll ask them questions related to their breasts; when they had their last mammogram, any family history of breast cancer and so on. The next step would be to examine them and take pictures and measurements. The photos do not show their face. Of course, and there's always another woman in the room with them, whether it's my office manager or a nurse. I'll let them get dressed and get comfortable and then I'll spend another half hour going over every facet of the operation; everything they'll need to know about breast augmentation, so when they leave the consult, every question on their list has been answered. It's extraordinarily rare that someone would come up with a question that I haven't already answered. They'll walk away as mini-experts on augmentation. I spend a full 45 minutes with them; it's the longest consult in my practice. I go through a tremendous amount of detail with them.

BI411: Do you prepare them for the emotional ups and downs they may go through?

Dr. Berman: I touch on it. In my practice, I've had very little post-operative depression; there's always a little bit of anxiety, but I've never had a patient that wasn't thrilled with the results. I do tell them that it's normal to swell. The swelling is always disproportionately in the superior aspect and it takes time to get your final shape. They're mentally prepared for that; I really do take them through things very extensively; we'll talk about the post-operative discomfort and what they can do to alleviate it. I keep in very close touch with them; I talk to them virtually every day in the post-operative period. They're really hand-held through the process so I've had very few problems with patients being unexpectedly upset or disappointed.

BI411: Are there any particular procedures or techniques you favor over others?

Dr. Berman: Virtually 100% of my augmentations are put behind the muscle. I almost never put them above the muscle. I feel the results are better going below the muscle in the long term. I always use saline implants. Beyond that, you have to customize; some women need a lift, some don't, some women need a simple lift, some a more complicated lift (mastopexy) and that's really a function of their body shape. A lot of times they'll combine other things they want to have done. It's not uncommon to have a breast augmentation and a liposuction carried out at the same time.

BI411: For a lot of exotic dancers, unusually large breasts are almost like a uniform. When a woman comes in looking for very large implants, but she tells you it's part of how she makes her money, do you try to talk her out of the decision, or do you grant her wishes?

Dr. Berman: In my twelve years, I've had strippers and dancers come in and they've all been pretty reasonable in what they wanted. Someone once emailed me who wanted 1200cc implants which are just humongous and I didn't reply. To a large extent, I feel I'm a technician and my job is to satisfy the desires of my patient. I don't feel it's my decision to say if they should be bigger or smaller; I'm really providing a service for the individual. As long as it's within normalcy, I wouldn't have a problem. If it's something extreme, I'd have to deal with that on an individual basis.

BI411: You're famous as the surgeon who put John Wayne Bobbitt back together. How did you originally get the call for that?

Dr. Berman: It was pretty unexciting, actually. I was relatively new to the area at the time when it occurred. I was one of the only people in the area who are skilled in microsurgery. Even though I wasn't on call they asked me to come in and review the case. It requires rather specialized training. I was quite surprised that it captured the world's attention like it did. I thought it would be talked about around the hospital and forgotten the next day. It caught the local media and then caught the world's attention and snowballed into a huge media circus that lasted for over a year.
Even the Washington Post had some little blurb about Bobbitt almost every day for a year. In Newsweek he was mentioned five weeks in a row! It was pretty incredible; it wasn't just Howard Stern, the mainstream media was carrying it extensively as well.

BI411: Was there any doubt at the time that it would ever work again?

Dr. Berman: In terms of it working, I had never done one or seen it done. Until you release the tourniquet and see the blood flow, you don't know if it's going to work, so that was a tense moment. I had no idea how long it would take or if he'd ever get function back, so that was a pleasant surprise that it worked so well and so quickly. Even though I went through an extremely good training program, we never encountered that trauma. Fortunately, it's a pretty rare injury in our society. It was really learning as I went along.

BI411: After all was said and done, did you get similar cases because of the publicity?

Dr. Berman: My wife and I actually talked about that and we thought there would be a lot of copycat crimes, since that's the nature of society, but in reality, no. There was one similar instance out in L.A., but that was it, fortunately. We kept joking around that I'd get some surreptitious call in the middle of the night by somebody with similar circumstances and needed me to help them out, but it never happened!

BI411: What do you think of the Internet as a form of referral compared to word of mouth?

Dr. Berman: I get a fair bit of business from the Internet (www.bermancosmeticsurgery.com). There's nothing that's going to beat work of mouth; if your best friend had a good experience with a doctor, that's always going to win over a referral website that specializes in breast augmentation or liposuction. Having said that, it certainly does generate business. The great advantage is the women that come to me from a website most of the time have been given information that is quite accurate. The patient can come in fairly well informed. I think the Internet is important, but I don't think the Internet will ever replace the referral of a satisfied patient.

BI411: With a career as time and mind consuming as plastic surgery, how do you find balance between your career and a personal life? Do you have personal past-times?

Dr. Berman: I think you'll find in general, most plastic surgeons have a life outside of medicine. I've got four little kids; they're 4, 6, 9 and 10, and two big dogs, a German Shepard and an English Mastiff. I also do a lot of martial arts. I do one style called Thai boxing and another called Brazilian Ju-Jitsu. I'm very interested in physical fitness. I spend four sessions a week in martial arts. I'm no Bruce Lee, but it keeps me from getting old and fat! I'm the second oldest person in Thai boxing and the oldest in Ju-Jitsu. The people I'm dealing with are in their 20's for the most part. It's a great group of people and they really push me to the limits. It's a good stress breaker because I come home tired and then I go to one of these very, very intense physical classes for an hour and a half and it perks me up.

BI411: Do you bring any of this to your practice? Do you talk to the women about the physical fitness they're maintaining in terms of the healing process after the operation?

Dr. Berman: I talk to them about what they can do and what they can't do and how quick they can get back to exercise after liposuction and tummy tucks. I've done a lot of fitness instructors and exercise buffs, so we definitely talk about those aspects. It's a very important issue for them.

BI411: If you could dispel one myth about plastic surgery, what would that be?

Dr. Berman: The public perception that a significant number of women get plastic surgery for somebody other than themselves. From my experience, 99.99% of the women I see, whether it's for breast augments, lipo, blepharoplasty, or any other operation, they're doing it for themselves. In the vast majority of the cases, the husband, boyfriend or significant other, is at most moderately supportive and a lot of times fairly neutral. You want the husband or boyfriend to say, "Look, I love you whether you have big breasts or small breasts, or big hips or small hips, it doesn't matter to me, so why bother?" Therefore it is a very personal decision for the woman.

The other myth is that this is some unhealthy urge that women are pushed into by society. I sometimes think of cosmetic surgery like changing your clothing. Looks aren't everything, but they can help make us feel good about ourselves. If somebody has a feature that isn't desirable, I don't see it as obsessive to want to correct it. Nowadays, it's very easy and quite safe to correct. It's not that much different than if you spent the money buying a nice outfit to make you look good, except that this is the outfit that you always wear because this is your body.

BI411: We find more and more women who come to our site searching for plastic surgeons are taking into account the age of the doctor, and are favoring younger surgeons over the more standard axiom of "looking for twenty or thirty years of experience". Do you feel it's because they may feel younger doctors may keep more up to date on technologies, or perhaps because they're doing their research on the web in the privacy of their own homes, there's a possible fantasy factor- since this is such an intimate operation that deals directly with her sexuality. Do you have any views on why many women prefer younger doctors these days?

Dr. Berman: Two things come to mind. One, you do want someone who is up to date and the other thing is it's really a question of relationship. I wouldn't put quite the same spin that you put on it, but it's nice if you can have a rapport with your surgeon, where you're comfortable. Each surgeon has his own style. I'm very professional, but I'm also less formal. I'm still called Doctor Berman, but I don't always wear a tie. My whole manner is a little bit more relaxed and I have found patients feel comfortable with my style. It's nice if you can talk to your doctor. It may be easier to do that with someone who's in their 30's or early 40's rather than someone in their late 50's or 60's.

BI411: Does the Bravabra work?

Dr. Berman: In all fairness, I have no experience with it. I'm extraordinarily skeptical that it's going to be even a quarter as successful as the advertisements are suggesting.

BI411: Any thoughts on endoscopic surgery for breast augmentation?

Dr. Berman: I think it has little use for breast augmentation. I do use endoscopy for forehead lifts and other surgeries, but not for breast augmentation. It's not that it can't be done, there are surgeons publishing results that seem reasonable. There has to be a higher complication rate and the scars on the breast from standard surgeries heal so well that I think it's a technique waiting for a reason to be created. I think it's really a marketing tool.

BI411: One of the most disturbing trends in the last few years has been the rise of non-board certified doctors like dentists, ENT's and dermatologists practicing plastic surgery in their own operating rooms without being properly trained.

Dr. Berman: One of the things that are so unfair to the public is the misconception of who actually is a plastic surgeon. The term "plastic surgery" is essentially trademarked. You can't call yourself a "plastic" surgeon unless you are certified by the American Society of Plastic Surgeons. What you can call yourself is a "cosmetic surgeon". In the public's mind, people just believe that a cosmetic surgeon is a board certified plastic surgeon. It's unfortunate, because even in the Yellow Pages, people see all the listings in the plastic surgeon section and just accept that they're all board certified, when over half the people in there are not. That's the very first question people should ask when they see a surgeon, but they usually don't.

BI411: What breakthroughs do you see in the future of plastic surgery?

Dr. Berman: The trend is to get more and more natural rejuvenations. There's a real concern amongst younger plastic surgeons to try to make the patient look more like themselves and remain natural. One of the big flaws from the 70's people who have had umpteen plastic surgeries and now look very unnatural. So there's certainly a trend in trying to be natural and use more and more subtle techniques to achieve it.

Also, in the reconstructive field, with all this tissue cloning, it's only a matter of time until people are able to clone tissue parts that are missing. So if you're missing your ear due to trauma, they will be able to take cells and clone a perfect genetic match for your ear.

BI411: Do you see a time when plastic surgeons will become genetic engineers?

Dr. Berman: It's certainly going to be interactive. As things get more and more specialized you'll probably have people that are in charge of cell development, then next person will take those cells and create an organ and put it back in the body.

You can't help but like Dr. Berman. Hundreds of women have trusted him with this most intimate of surgeries and come away with heightened self-esteem and a new life-long friend. Call him at (703) 406-2444 and take that first step toward a new you.

Visit Dr. David E. Berman's profile on Breast Implants 411