I went to Dr. Brownstein, though Dr. Garramone was on my list. For me it turned out if I had to travel and stay in a hotel, I might as well make a vacation out of it. And since I'd never been to San Francisco, I went there. Dr. Garramone does have an excellent reputation for doing a great job with heavier guys.
I was heavier when I had my surgery, and while I loved my flat chest I hated the scars and 'boxiness' of my chest. Now that I am normal weight, I love my chest, except for the scars. The scars are fading, but it takes my scars a few years to fade, from experience.
I know Dr. Brownstein does internet consults (ie you contact him, then he'll ask for pictures). I think Dr. Garramone does the same.
Jay