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Monthly Archives: July 2013

The Gynecomastia Consultation, What to Expect

Miguel A. Delgado, Jr., M.D. - Gynecomastia Specialist

Miguel A. Delgado, Jr., M.D.
Gynecomastia Specialist

San Francisco, CA-Most patients are nervous when they have an appointment to see the doctor. This is especially true for patients seeking elective procedures as they have additional concerns about vanity and may feel guilty for indulging in something that is not necessary but will make them feel better about themselves.

It is the exceptional office that has a staff that understands the feelings of the new patient and has the ability to make them comfortable from the moment they arrive for their first consultation visit.

When arriving for a gynecomastia initial consultation, the patient will be escorted to an exam room and will be joined by Dr. Delgado. Dr. Delgado’s warm and friendly manner puts patients immediately at ease. Many patients have made the comment that they do not feel that Dr. Delgado talks down to them as many doctors are known to do, but more on an equal basis that builds trust and allows the patient to feel comfortable asking any questions that they may have.

To begin the consultation, Dr. Delgado has several questions he will ask. Usually he will want to know how long the patient has had male breasts, and when did they develop. He will want to know if there has been any noticeable change with weight gain or loss. Does he take his shirt off in public? Do other men in the family have gynecomastia? And what are his goals?

At this point,  Dr. Delgado explains his surgical technique of excision combined with liposuction, pointing out that liposuction alone is only for the patient that has what is known as “pseudo-gynecomastia”, meaning fat alone is causing the male breasts. He points out that 40% of his gynecomastia cases are now revision surgeries, due to the original surgeon using liposuction alone and leaving breast tissue behind.

He goes into great detail to explain how the incisions are placed around the areola so that after healing they are almost invisible.

Drains are placed at the end of surgery Dr. Delgado explains, in order to remove fluid that normally collects when there is a “dead space” left after removal of fat and tissue. He shows how a compression vest will be worn to assist in the healing of the chest, and that he has them custom made to include pockets for the drains. Further, he says that the vest will be worn for 6 weeks and after that all normal activities including exercise can be resumed.

Now Dr. Delgado will do an exam of the patient’s chest and will be able to give a personalized evaluation of what he recommends. After the examination,  the patient then will meet with Dr. Delgado in the office of the patient care coordinator. Dr. Delgado has several albums of before and after pictures of his male breast reduction patients that he presents. He will show where the incisions are and how they healed; he shows the small scar from the drain and how he now has it hidden in the armpit. These photographs will give the patient a good idea of Dr. Delgado’s work, and the results that can be anticipated.

Many patients choose to have additional surgery done at the same time to save money and recovery time. For patients that are interested, Dr. Delgado will show pictures of patients that have had a combination of surgeries. Popular add on surgery, for example, would be, liposuction of the love handles and/or abdomen, some may want facial surgery such as a rhinoplasty (nose job) or eyelid surgery or possibly a chin implant. Dr. Delgado will be happy to discuss additional surgery at the initial consultation if requested.

At the end of the consultation with Dr. Delgado, the patient then meets with the patient coordinator who will present the fees outlining gynecomastia costs and answer any additional questions the patient may have such as pre-operative and post-operative instructions, financing, and scheduling surgery. The patient is encouraged to call the office at any time with additional questions for the patient coordinator or Dr. Delgado.

In his quest to educate his patients and make them as comfortable as possible prior to the consultation, Dr. Delgado produced a 6 part video that is posted on his website and You Tube showing the whole process from the initial consultation to post-operative visits and the patients final impressions.

How to Lose Man Boobs

 

Before and After Gynecomastia

This 26-year-old San Francisco patient is 5’6” and 172lbs. He underwent glandular excision and suction-assisted lipectomy of the chest and axillae. From the axillae, I removed 400cc of fat from the left and 450cc from the right. From his chest, I extracted a total of 250cc of fat from the right and 202cc from the left. I also excised 35 grams of glandular tissue from the right side of his chest and 29 grams from the left side.

San Francisco, CA-What is gynecomastia? Gynecomastia, also known as moobs, man breasts, and man boobs are the description of the development of male breasts, it will affect 60% or more of all men at some point in their lifetime.

The question of possible non-surgical options for getting rid of gynecomastia comes up frequently for all gynecomastia surgeons from adolescents and men hoping to find a resolution to get rid of the male breasts without cosmetic surgery.

The cause for some types of gynecomastia needs to be ruled out before attempting surgery or non-surgical methods. For example, 90% of adolescents will find their gynecomastia will go away on its own after puberty with no treatment at all. If a patient is suffering from “pseudo-gynecomastia” which is caused by fat alone, weight loss or liposuction may get rid of the man boobs, but liposuction is a surgical procedure. Some men will find that losing weight or removal by liposuction will leave them with loose skin, and then may opt for surgical skin tightening.

For all others,  it is important to try to determine the cause of the development of male breasts so that it will not reoccur if surgical intervention is the choice. For example, many men develop breasts while taking certain prescriptions drugs, or steroids, or smoke marijuana or other illicit drugs. Consulting with a gynecomastia specialist is recommended to help determine the cause and to stop the offending drug or find an alternative.

There are men suffering with moobs that do not have surgery as an option. There are some measures that can be taken, but unfortunately, none will actually get rid of their gynecomastia.

One option that some men choose is to wear a gynecomastia compression type shirt; there are many styles and manufacturers to choose from and can usually be worn undetected under clothing. However, the compression vests can be binding and/or hot, and a trip to the beach or swimming or any activity that involves removing ones shirt, still presents a problem.

Exercise and lifting weights can build pectoralis muscles and will enhance definition, but the male breasts will remain, and the additional muscle mass may make them even more noticeable. Bodybuilders

If any research is done on the internet about gynecomastia, it is almost impossible not to see advertisements for herbal based supplements that allege they can reduce fat cells in size and quantity. The main ingredient is Chromium Picolinate, which is found in many over the counter diet products, and their fat reducing claims remain unsubstantiated. Even if they did work, they are only claiming a reduction of fat and not breast tissue which is present in all cases of true gynecomastia. There have been many reports on www.gynecomastia.org from men who have tried these products and they report very disappointing results. If you are tempted to try these products, before plunking down money, check Google reviews for the product, make sure that they are not posted by the company themselves as they have multiple websites and they do a very high volume of advertising.

The Mayo Clinic recommends that men who do not have surgery as an option seek psychological counseling and/or find support groups with other men suffering with gynecomastia, such as www.gynecomastia.org. There is comfort to be gained by learning how others deal with their condition, and many stories are shared on this popular site. For some men learning to live with gynecomastia without self-loathing is definitely an option.

Men who are able to have male breast reduction surgery and choose this option have an extremely high patient satisfaction rate.  For several years in a row male breast reduction surgery has been on the increase, The American Society of Plastic Surgeons (ASPS) reports that for 2012, there was an increase of 5% over 2011.

Gynecomastia, a Term Most Parents Don’t Know

Adolescent before and after gynecomastia

This is a 17-year-old resident San Francisco Bay Area, California who presents with gynecomastia. He underwent gland excision and suction assisted lipectomy with 150 cc of fat aspirated from each side.He had 46 grams of tissue removed from his right chest and 400 grams of tissue removed from his left. His postoperative photographs are taken 3 months after surgery.

San Francisco, CA-Gynecomastia, often misspelled, mispronounced, and misunderstood. Most people are not aware that having male breasts is a condition that can be caused by many different factors including, heredity, prescription drugs, illegal drugs, steroids, Klinefelter’s syndrome, puberty, aging, weight gain, and cancer of the male breast. For some, the cause remains unknown. If a pediatrician tells parents that their son has gynecomastia, many ask “what is gynecomastia?”If parents haven’t heard of the condition, how can they help their sons?

In 1995, there was an episode on Seinfeld where Kramer one of the main characters, invented “the Bro” also to be known as “the Manssiere”, a bra for men. This episode brought humorous attention to the condition except for those that suffer with male breasts. Negative attention has been in the media off and on ever since with cruel descriptive words like; man boobs, moobs, bitch tits, he-hooters, dude rack, man cans and more.

As boys enter puberty, it is not uncommon for them to develop female type breasts or what is termed as “puffy nipples”. At an average age of 13, this phenomenon is usually brought about by hormones being out of balance, but usually when the hormones even out the breasts will disappear. When the hormones are raging, for both boys and girls, they can become extremely emotional and sensitive and for good reason, their bodies are going through a lot of changes. This can be a very confusing time for young people and having supportive parents can make all the difference in the world.

As much as 40% to 50% or more young men going through puberty will develop some degree of gynecomastia on one or both sides. A visit to the pediatrician is in order to monitor any breast growth. For 90% of young men, the gynecomastia will resolve on its own within a few months to a couple of years. For the small percentage of boys that the gynecomastia remains, parents ask, “what is the treatment for gynecomastia?” There are no known treatments that can reverse the formation of breast tissue once it has remained past puberty except male breast reduction surgery. The good news is that the male breast reduction procedure is very successful with almost no evidence of surgery having been performed.

Gynecomastia can be demoralizing for any man, but for young boys who do not understand what is happening to their body, it can be devastating. Most feel it is their fault and experience incredible shame. They are not comfortable telling anyone what they are going through and do their best to hide their chest with loose fitting shirts. They avoid situations where they might have to bare their chest, such as going to a pool or the beach. It is amazing how many young boys are able to hide their breasts from their parents and hide the agony they are experiencing. Classmates can be especially cruel with teasing and name calling for the boy with breasts.

It is hopeful that parents will notice any unusual breast development in their son so that they can be good support for them. If it is before puberty starts or before 9 years of age it could be a more serious complication, and he needs to be seen by a physician. Search engines on the internet make information readily available. Family members or friends who have some knowledge of gynecomastia may take parents aside and guide them to seek help for their son. Pediatricians are in a position to alert parents and educate them and their son.

The World’s best resource for information on gynecomastia is www.gynecomastia.org. There is a directory of Board Certified Plastic Surgeons throughout the United States. The site offers many before and after pictures of male breast reduction patients, a blog page with interesting articles posted by member surgeons.

The most popular and active section of the site is the forums. One of the most popular forums is called “gynecomastia talk” where boys and men can share questions and experiences, and then there is a forum called “your stories”, one called “ask a doctor” whereby guys can post questions to the surgeons who are members of the site.

Another forum is called “surgery success stories”, this section has several stories written by boys and/or their parents. One in particular tells of a boy who had been silently suffering with his gynecomastia breasts for a long time and finally in an attempt to hide them better ordered a compression shirt that was supposed to help flatten his chest. His package arrived when he wasn’t home, and his Mom saw it first. When he came home and saw her with it he was beyond embarrassed, but it turns out his parents were very supportive and even willing to down-size their house in order to have enough money for him to have male breast reduction surgery. He didn’t allow that to happen, but the door was now open for them to have good communication and find a way to resolve his problem. This incident helped him to have a closer relationship with his parents.

There are many similar stories posted on gynecomastia.org. Unfortunately, not all young men are so lucky to have such supportive parents, but many of the forum members encourage young men to try talking to their parents. For those that do not have a good support system, gynecomastia.org is even more valuable. Many boys and men have found the support they need from other forum members, with ways to deal with all the different issues gynecomastia presents.

before and after photo - banner

 

__ Contact Us For a Consultation

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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