First, I use ladder stand-offs so as not to cause damage to your gutters. Then I personally clean your gutters by hand, making sure nothing gets left behind. Cleaning by hand also helps me to see up close if there's anything you should be concerned about regarding the condition of your gutters. I'll let you know if there is. I'll take the time to carefully inspect your downspouts as well.
I pride myself on my perfectionism. All of my work is satisfaction guaranteed. Absolutely all debris preventing your gutters from properly draining will be removed.
My recommendation is to have your gutters cleaned thoroughly once a year. This will help prevent unnecessary damage being caused to your gutters and will protect your downspouts too.