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Monthly Archives: December 2009

Marin Cosmetic Surgery Center For Male Breast Reduction


When going through the process of selecting your plastic surgeon for gynecomastia surgery, another important factor to consider is where is the procedure being done? Many surgeons use a local hospital or surgical facility with multiple operating rooms.  In many cases the outcome may be fine, but there are definite advantages when the surgeon has his/her own private surgery center.

First quality control; you have only one operating room. That means less traffic going in and out of the surgical surgeryfacility, which reduces the risk of infection dramatically.  Infection is one of the greatest risks in surgery, the ability to control and reduce the probability is extremely important.

Second, the surgeon would be in charge of ordering his own medical supplies and instruments, therefore monitoring quality and “state of the art” equipment at all times.
Third, the surgeon has command of the surgical staff, he is able to pick and choose the team with the best qualifications and skills available to him. The surgical team must be “in sync” with the surgeon in order to obtain the best possible outcome.

While picking the best surgeon is extremely important, the surgeon’s “team” can make or break him.  Having a team that the surgeon has trained himself allows him to focus on the patient and not be concerned with the skills of the staff he may have been assigned to for the day as can happen in a hospital setting. Gynecomastia is a surgical procedure that only a handful of plastic surgeons specialize in;  a surgeon that also has his own surgery center and trained team is  optimal.

And lastly, check the credentials of the surgery center. Marin Cosmetic Surgery Center, is a fully accredited surgery center, meeting Medicare Guidelines, and the American Association for Accreditation of Ambulatory Surgery Facilities, Inc.(also known as Quad A) thus awarding it the distinction of being a “Surgery Center of Excellence”.

Gynecomastia Surgery Recovery With Drains


Drains are a surgeon’s choice based on his procedure.  There is no right or wrong answer.  Each surgeon must deal with the outcome and complications of “drain or not to drain”.

I drain!  The surgery that I perform for the average gynecomastia patient is an aggressive and wide exposure approach.  This creates a large area of “dead space” or open space.  This pocket has a large area of “raw space”, which loves to ooze fluid.  A drain will collapse the space, evacuate the fluid and create a negative pressure to the cavity, which encourages it to close down.  The addition of the compression garment creates a perfect environment for healing.compression vest

Early in my career, I used drains based on the complexity of the case.  Greater than 10% of the time, I had fluid accumulation inside the dead space area.  This is called a seroma, not an accumulation of blood, but of yellow body fluid.  This complication is easily corrected by needle aspiration every four to five days until the cavity is collapsed.  But, it is very inconvenient for patients.  Also, there can be prolonged healing.  In the end, all works out perfectly if the complication is dealt with properly.

I have learned from my experience over twenty years.  I drain all cases, except those that are candidates for the “Light Procedure“.  Allow me to explain further.

The drainage output allows me to see what is going on inside!  By the consistency of the fluid, thickness, and the speed at which it is coming out, it can alert me and my staff to:

• Let’s observe him longer in the recovery room.
• Let’s take off the garment to see if swelling is occurring due to a blood accumulation.
• The fluid is thin.  Great!  All looks good.

As a surgeon, this gives me valuable information.

I see mDelgadoany patients from out of town.  They need to heal uneventfully.

My seroma or fluid accumulation rate is near zero.  However, there is a price or tradeoff!  The small scar from the liposuction or drain site has been a point of concern for patients.  Sometimes, it is more obvious than the incision around the areolae for glandular excision.  My patients have educated me about this over the years and now I have an instrument to take the incision high up in the armpit and go towards the back.  Listening to your patient is the most valuable thing in a plastic surgery practice.  This is a win-win situation.  I get my drain and the patient’s have to search for their drain incision!
Miguel A. Delgado, M.D.

Soy Milk Possible Cause of Gynecomastia, Enlarged Male Breasts

In an earlier blog we looked at  lavender oil and the possibility of it causing moobs, due to many recent articles about soy milk as a possible culprit we have quoted a couple of articles for your consideration. But keep in mind, the bestsoy milk way for you to discover what your particular cause may be is to be evaluated by your doctor who may refer you to an endocrinologist. It is very possible that what might cause gynecomastia in one man may not cause it in another.
According to USMagazine.com in a November 3, 2009 article; Jeremy Piven is suggesting that drinking too much soy milk led to growth of male breasts. Apparently soy milk has a lot of estrogen and that can cause feminine characteristics to develop in males. It has been proven that soy foods lower sperm count in men.
The lesson to remember is that excess of anything is bad and that is what he was doing, drinking up to 12 cups of milk a day. You don’t have to give up your soy consumption in form of tofu or milk as long as you eat it in small amounts. In case you already have them, then moob surgery is an option.

Jeremy Piven blames his impressive man boobs not on age or a lack of exercise, but soy milk.
“I was the guy that dabbled in soya milk, but now I’ve found out soya milk has enough estrogen for me to grow breasts; I had to put the soya milk down. It was a very confusing time.”
Despite the fact that Jeremy drank almost four times the recommended daily allowance of soy and more than double the amounts used in clinical testing, there is no scientific basis to his claim. According to a nutritional expert from St. Catherine University in Minnesota a study was released on hormones in men and their relation to soy. “Usually, studies only go as high as 150 mg of isoflavones a day. And a reasonable intake would normally be about 100 mg a day, which are four full servings of soy. Soy has been studied extensively for 20 years,” she says, “and we haven’t found man boobs yet.”

Then there is an interesting article in Men’s Health addressing this issue, we have copied and pasted some of it for you below, for the full article go to: www.menshealth.com
Is This the Most Dangerous Food for Men?
Jim Thornton
The unassuming soybean has silently infiltrated the American diet as what might just be the perfect protein source: It’s cheap and vegetarian, and could even unclog our hearts. But there may be a hidden dark side to soy, one that has the power to undermine everything it means to be male
James Price’s breasts had been painful and swollen. It looked as if gum balls were implanted underneath each nipple. The slightest touch triggered throbs.

For Price, a retired U.S. Army intelligence officer who once flew attack helicopters in Vietnam, these changes were more than just physically uncomfortable. “Men aren’t supposed to have breasts,” he says today in a quiet Texas drawl. “It was like my body was feminizing.”

Gynecomastia Before and AfterThe first three doctors Price consulted diagnosed him with gynecomastia, or the abnormal enlargement of the mammary glands in men. Tests further revealed that estrogen levels in his bloodstream were eight times higher than the normal limits for men, higher even than the levels typically seen in healthy women. Price’s estrogen was so high, in fact, that the doctors were at a loss to explain it. One physician became so frustrated he eventually accused Price of secretly taking estrogen. “He thought I was a mental case,” says Price, still angry as he recalls the experience.

Dispirited and in pain, he decided to try one more doctor, this time a fellow military man. He made an appointment with Lieutenant Colonel Jack E. Lewi, M.D., chief of endocrinology at the San Antonio Military Medical Center. During that first meeting, neither doctor nor patient had any inkling of just how long and complex this medical mystery would prove to be. Dr. Lewi initially checked for “usual suspect” lifestyle factors known to trigger gynecomastia, from alcoholism to certain herbal ingredients, like tea-tree oils and lavender..

In the classes that Dr. Lewi teaches to medical students and residents, he has long offered this advice: If you’re not finding the right answers, you’re not asking the right questions. Though he’d asked Price about his lifestyle and habits innumerable times, he decided to go back once again, and this time to make his questions as specific as possible. “I said, ‘Let’s go over your diet, meal by meal, and you tell me every single thing you eat and drink.’ He said, ‘Sure, Dr. Lewi. I get up and usually have some cereal.’ I said, ‘Do you put anything on it?’ He said ‘Soy milk.’ ”

Price explained that he’d developed lactose intolerance in recent years and had switched to soy milk exclusively. It had, in fact, become one of his favorite drinks, a great thirst quencher in the Texas heat.

He asked Price how much soy milk, on average, he drank each day. “He told me, ‘Probably about 3 quarts,’ ” recalls Dr. Lewi about the moment that changed everything.

Of course, most medicines have side effects. And when you consume soy protein, you’re actually courting the Mr. Hyde side of two natural drugs: genistein and daidzein. Both act so similarly to estrogen that they’re known as phytoestrogens (plant-produced estrogens). Soybeans couldn’t care less about human sex characteristics—genistein and daidzein may have evolved to act as chemical defenses against fungi and grazing animals. (They aren’t very effective deterrents, apparently, since soy meal is widely used to feed livestock.) But when humans consume these compounds in high enough quantities, they may experience gender-bending nightmares like James Price’s. What’s more, studies of these phytoestrogens in leading peer-reviewed medical journals suggest that even lower doses—such as the amount in the 25-gram soy protein target cited by the FDA—have the potential to wreak hormonal havoc.

So again, it is important to be aware of your own specific diet and habits so that you can discuss them with your doctor/surgeon.

Male Breasts and Cancer

 What? Breast Cancer in Men??

   When Rob Fechtner of Napa woke up one morning in 2006 to a sore spot on his chest and a strange indentation in his nipple, his first thought was that he’d pulled a muscle. Even his doctor told him it sf chroniclewas probably nothing to worry about.
But the inverted nipple bothered him, and with a little online research he learned it was a symptom of breast cancer – in men as well as women. He pushed his doctor for a mammogram, and two days later he learned that he did, in fact, have breast cancer. He’s since had a mastectomy and been treated with chemotherapy.
“Before I went on the Internet, I had no idea men could get breast cancer,” said Fechtner, 51. “I should have known in the back of my mind that it was a possibility. We need to get the message out there to men.”

Monday, December 7, 2009 (SF Chronicle)
Men need to check for breast cancer, too Erin Allday, Chronicle Staff Writer
The above is an excerpt from a recent article in the San Francisco Chronicle. There has been very little information in the media about breast cancer in men. When men come in for a consultation with Dr. Delgado, most are surprised when told that men can get breast cancer, however according to the American Cancer Society  it is usually in men of an average age of 67.  Some breast cancers are linked to inherited (from either parent) mutations of the BRCA1 or BRCA2 tumor supressor genes. While it is very rare in men…less than 1 percent of all breast cancer cases in the United States according to the American Cancer Society, it must be addressed when evaluating any breast surgery for men and women. That is why anytime Dr. Delgado does a breast reduction surgery, breast tissue samples are sent to pathology.

Dr. Delgado has done many breast reduction surgeries for women. Twice he has had the pathology report come back positive for breast cancer. This is devastating news to share with a patient that has just undergone surgery, but most likely has saved their lives.

Better news for men, of all the gynecomastia cases Dr. Delgado has performed, none of the pathology reports have come back positive for breast cancer. That does not mean you are not at risk, most people know of at least one man who has had breast cancer, or you may not be aware of it because men are much less likely to discuss it.microscope

Many men, on hearing the requirement of the pathology test, request not to have it done in order the save the additional expense, which can run as high as $500. This is not where you want to save money…this can save your life. If you have private insurance, most likely your insurance company will cover the cost.

before and after photo - banner


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To schedule a consultation with Dr. Delgado in San Francisco, California or Novato in Marin County call 415-830-8883. You may also send us a e-mail at info@DR-Delgado.com or fill out our quick contact form. Send photos of your chest for a complimentary virtual consultation TODAY. We have a complimentary travel package for out of town patients that include travel to and from the airport, four nights stay at the Novato Oaks Inn and travel from the hotel to the office.

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(415) 898-4161


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