26 year old male who presents with adolescent gynecomastia. He is 6 feet tall and weighs 245 pounds. He had 50 grams of breast tissue removed from his right chest and 77 grams from his left . He had 250 cc. of fat and aspirate removed from each side of his chest. His post op course was uncomplicated.
A seroma is a collection of clear serous fluid most often at a surgical site where tissue has been removed. This can be a complication after gynecomastia surgery. The swelling and fluid may not happen right away but can develop several weeks after surgery.
Seromas Lead to Serious Complications
Usually, a seroma will resolve in a few weeks, but the accumulation of fluid will cause the skin to sag and may cause discomfort. In some cases, a seroma can lead to serious complications, such as infection, and delayed wound healing. If an infection should occur, it may have developed into an abscess requiring medical treatment. The patient will be instructed to notify the surgeon of any noticeable swelling or abnormalities.
Small seromas may resolve on their own, but if left untreated they may calcify and form solid knots. Larger seromas may require needle aspiration or even drain replacement.
Methods of Prevention
Drainage is the most accepted method of prevention along with a compression garment. A compression vest will help the skin and tissue heal faster, reduce swelling and bruising and reduce the risk of developing a seroma.
A hematoma is different than a seroma in that a hematoma contains red blood cells, and an abscess is different as it contains puss from an infection.
Drains and Compression Vests
Some surgeons do not use drains, and some do not use compression vests after gynecomastia surgery. Dr. Miguel Delgado, M.D. not only advocates the use of drains, he also is a firm believer in compression vests. Dr. Delgado designed his own compression vests that he makes available to his patients. His custom-made vests have pockets for the drain bulbs to rest in, instead of being attached with safety pins. These custom-made vests additionally aid in binding the chest tissues together, decrease post-operative pain, and increase blood flow.
Dr. Delgado has over 25 years of gynecomastia surgery experience, and he states that his incidence of complications is very minimal. Call today (415) 898-4161 for a consultation for any gynecomastia issues you may have.
Before and After Gynecomastia Surgery for a Body Builder
Steroids and Body Builder in 6 Part Video
Dr. Miguel Delgado, M.D. presents a 6 part video where he performs a double incision mastectomy with a free nipple graft. Dave, a body builder, has severe gynecomastia due to his steroid use. This procedure can also be used for a man who has had massive weight loss, or someone with severe gynecomastia with excessive skin.
The video series will take you through the pre-operative visit, live surgery, to post-op visits.
Dave’s Steroid Use and His Story
In Dave’s story, he tells us he had been on steroids a long time before he had any development of male breasts. He did not notice any changes in his breasts until he stopped the steroids. He tells Dr. Delgado that he did not take any anti-estrogen as he was unaware of steroid side effects.
After he weaned himself off steroids and losing some weight, he became aware of his breast development. He was hoping that if he lost weight his male breasts would also reduce but found that was not the case, he learned that only the fat around the breast tissue would increase or decrease but not the breast tissue. The breast tissue is permanent, and surgery is the only way to get rid of it.
Dave tells Dr. Delgado how he lost his confidence as a professional athlete and trainer, once he developed breasts. He comes to Dr. Delgado for help so he can regain his confidence and be able to wear tight fitting shirts again.
Dr. Delgado explains that with surgery not all of the breast tissue is removed in order to have an aesthetically sculpted chest. Dr. Delgado warns Dave that if he should continue with steroids, it is possible that he could have a recurrence of breast tissue although not to the extent he now has. Dave states that he wishes to continue in moderation with steroids because as a man in his 50’s it is difficult to maintain his muscles in the way he wants. Dr. Delgado tells him that some men can take steroids with no adverse effects while others can take small amounts and develop breasts.
Exciting Results After 5 Months!
In the last video, you will see Dave at 5 months post-op with an excellent result. He is extremely happy and has had no recurrence of breast development. View all videos below.
If you have male breasts due to taking steroids or even unknown causes, call Dr. Delgado (415) 898-4161 today for a consultation.
This man has suffered from adolescent gynecomastia. He underwent glandular excision and liposuction of the chest, total fat extraction of 500cc from the right side and 450cc from the left. Total glandular tissue removed was 17 grams from the right side and 14 grams from the left.
Considerations For Surgery
The best time to have male breast reduction surgery is when you have decided to do it! However, if you are flexible, there are some things to consider when scheduling your surgery.
After surgery, you will be wearing a compression vest for the first 6 weeks of your recovery. In the winter time, the compression vest will keep you warmer as you will be wearing warmer, heavier clothing that will hide the vest.
Hiding Male Breasts
Wearing baggy clothing is how many men hide their male breasts, and after surgery, to conceal their compression vest. The compression vest isn’t as difficult to hide, as Dr. Miguel Delgado, M.D. has designed his own compression garments that are more comfortable and functional than other vests. However, for the first 2 or 3 days you will have drains in place, and even with the convenient pockets in the Delgado vest for the drains, it is a little bulky and easier to hide under a heavy shirt.
Enjoy Your Summer
Summertime is when men want to spend more time outdoors wearing tank tops, T-shirts, and even going shirtless. Having surgery in the winter time will allow your recovery to take place before the summer months. Dr. Delgado recommends that you still use sunblock on your scars for a good 6 months and even up to a year. As long as the scars are still pink, you need protection with sunscreen of at least 30 SPF, to avoid hyperpigmentation (scars turning permanently dark). Regular shirts and T-shirts do not protect scars from the sun’s rays, use a good sunscreen.
After gynecomastia surgery, you will need to take a break from your exercise program for 4 to 6 weeks. If jogging, bike riding, or other outdoor activities are your exercise choice, missing a few weeks in winter may be preferable than the pleasant days of summer.
If you have been thinking about gynecomastia surgery, now is the time to schedule a free consultation with Dr. Miguel Delgado at (415) 898-4161.
You may know some of the common causes of gynecomastia such as; puberty, steroids, medications, and aging. However, there are some lesser known ones that you should be aware of.
Men have more androgen hormones and women more estrogen, but when the ratio gets out of balance for men, the result could be man boobs.
The following are some more obscure reasons that men may develop male breasts, but Dr. Miguel Delgado, M.D. wants to remind men that sometimes the source of gynecomastia remains unknown.
• Deprivation Diets
If you should go on a strict diet that deprives your body of needed nutrients, testosterone levels will fall, but not estrogen levels. Men may not grow breasts while on a deprivation diet, but they may find when they return to a normal diet, they may develop breasts. The term for this is “re-feeding gynecomastia.” This phenomenon was first noted when prisoners of war returned to the U.S. after World War II. When the soldiers returned to a normal diet, they developed breasts.
• Weight Gain
The ratio of muscle to fat gets thrown off when one gains excessive weight. As the proportion of breast tissue to fat rises, the body will produce more estrogen, the female hormone, and not as much androgen. When this occurs, breasts may develop.
• Alcohol and Beer
Consuming alcohol and beer will put on pounds and if in excess could lead to cirrhosis of the liver. It is hard for the body to rid itself of estrogen and phytoestrogen which are present in hops that are in beer and other plants in hard liquor. The liver metabolizes hormones, and if the liver is somewhat compromised, it may convert androgen into estrogen leading to female type breasts.
• Cigarette Smoking
It is known that cancer produces hormones for its own growth which results in imbalances and can then grow breasts on men. Various types of cancer may cause gynecomastia such as testicular cancer and lung cancer. More reasons to try to quit smoking for good!
• Rifle Shooting
This may be the most surprising reason for the growth of male breast tissue. It was discovered that 70% or more German military men who perform precision drills, develop gynecomastia. It is unknown what causes a rise in estrogen from a rifle backfire!
When consulting with Dr. Delgado for gynecomastia, be sure to inform him of all meds, your family history, and lifestyle, to help him determine the possible cause for your male breasts.
If you have been researching gynecomastia, you probably have heard of numerous things that can trigger gynecomastia, such as; puberty, steroids, illegal substances, obesity, aging, alcohol, hormonal imbalances, medications, etc.
There is one gynecomastia cause that you might not have heard about, and that is Tribulus Terrestris which is an herb used as a nutritional supplement that enhances testosterone production. In addition, the herb is touted to increase sexual function, improve muscle recovery, and exercise performance.
Increased Estrogen Equals Man Boobs
However, with all these great benefits there is a downside to this herb, and that is it may cause gynecomastia. Tests have shown the herb increases testosterone levels producing a hormonal imbalance. As a consequence, the body will produce more estrogen resulting in man boobs.
There are many other herbs that have been associated with gynecomastia, some of them are; tea tree oil, lavender oil, grape seed, dong quai, saw palmetto, ginseng, to name a few.
Some Foods are Estrogenic
Furthermore, there are foods that are considered to be estrogenic, such as; soy products, legumes, chickpeas, and cowpeas, and some red meats that come from animals raised on synthetic hormones. Consuming too many foods that are laden with estrogenic substances can affect the balance of hormones resulting in breast growth.
Before and After Gynecomastia Surgery
Trying to self-diagnose what may be responsible your female type breasts is nearly impossible. Dr. Miguel Delgado, M.D. advises men to seek the advice of a Board Certified Plastic Surgeon who specializes in gynecomastia. Be sure to inform the surgeon of all supplements, herbs, medications, diet, lifestyle, and family history to help find the source of your gynecomastia.
Some Gynecomastia Causes are Unknown
Finally, it is possible that the origin of your man boobs may never be discovered, it remains unknown for many men. However, gynecomastia is not a life-threatening condition although for many it causes severe embarrassment. Whatever the source, surgery is the only proven treatment for permanent removal of male breasts.
You no longer have to feel ashamed of your male breasts, call today (415) 898-4161 for a consultation with Dr. Delgado who has been performing male breast reduction surgery since 1988 and is an expert in his field.
Note the red line below the breasts in the before surgery picture which is caused by bad posture, is diminishing in the after picture.
Bad Posture Has Consequences
Almost all men with gynecomastia adjust their posture by slouching their shoulders and some even bend their spine to hide their pronounced breasts. Slouching and bending of the spine can have serious consequences, causing misalignment of the skeleton and muscles. Bad posture can lead to back and neck pain, arthritic joints, digestive problems and even breathing complications.
Men with bad posture make them look weak, unconfident, and insecure, affecting personal relationships, and may hamper job prospects. Over time the continuation of hunching over may shorten or lengthen bones and joints and may become permanent.
Cortisol, the “stress hormone”
In addition, bad posture may cause problems with ankles, knees, shoulders, and hips, which will lead to back pain and headaches. Eventually, there will be wear and tear of the joints and ligaments, cartilage, and lead to inflammation. If your body has chronic inflammation, it will produce more cortisol in response to the stress. The energy needed to produce more cortisol will reduce the production of testosterone.
Confidence Improves With Good Posture
When you stand straight, you feel confident, and when you feel confident, you stand straight. Similar to smiling leads to happiness and happiness leads to smiling.
Good posture allows the spine to withstand the pull of gravity and affects energy expenditure, hormone production and quality of life. Correcting posture can be difficult, but when a man has male breast reduction surgery, confidence grows, and he will want to stand tall and proud.
Gynecomastia is a Life-Changing Event
Dr. Miguel Delgado, M.D. wants his patients to know that having male breast reduction surgery can be a life-changing event, not only giving a man confidence and the freedom to bare his chest but to end physical and mental conditions that affect his quality of life.
If your male breasts have been a source of misery in your life, call now (415) 898-4161 for a consultation with Dr. Delgado and start your road to recovery!
Risperdal is used to treat attention deficit disorder (ADD), bipolar disorder, and other mental issues. Dr. Miguel Delgado, M.D. states that studies have shown the drug can cause the development of female type breasts in men known as gynecomastia. Originally it was claimed that gynecomastia occurred in only 1 out of 1,000 patients. However, after being on the market for over 20 years, it is more than 20 times the original rate stated.
Risperdal Lawsuits Now Over 5,500!
In the first 3 months of 2017, more than 3,000 Risperdal lawsuits have been filed making the total now approximately 5,500. Last year one client was awarded $77 million, and there are several similar claims pending.
Johnson and Johnson canceled the tolling agreements on thousands of cases, which pauses the statute of limitations deadline, increasing the burden on the courts. Now there is no expiration date for filing a lawsuit; however, either side has the right to cancel the agreement.
So far 8 cases have gone to verdict in Philadelphia where the plaintiffs have won 4 and Johnson and Johnson have won 4. Appeals are still pending in Pennsylvania’s Superior Court.
TV Ads Attract New Claimants
You may have noticed millions of dollars are being spent on TV ads to attract new claimants for Risperdal litigation. In 2016 there were 3,800 TV ads that cost 2.6 million.
In 2016 74% of the plaintiffs did not live in Pennsylvania, which is not unusual for cases this size against pharmaceuticals companies. Now 36 states have filed lawsuits against Janssen, a subsidiary of Johnson and Johnson and the manufacturer of Risperdal, accusing them of hiding the dangerous side effects of the drug from health professionals and the public, and illegal marketing practices. Worldwide, Risperdal has profited over $30 billion.
Surprisingly, Risperdal is still prescribed by doctors and is not the subject of a recall.
If you have any questions or issues with female type breasts, contact Dr. Delgado now (415) 898-4161 for a personal consultation.
Posted on: September 20th, 2017 By: Miguel Delgado
Some men have voiced concern about the use of drains after male breast reduction surgery. They are somewhat cumbersome, and a little uncomfortable when removed, but the advantages greatly out weight the disadvantages.
Drains May Prevent Infections
Drains collapse the “dead space” that is left after surgery. Without the drain, the space may collect fluid and can cause an infection or other complications. The type of drain used is called a Jackson Pratt which uses mild suction removing fluids through a clear plastic tube from the surgery site to a small bulb that is placed in a small pocket of the compression vest.
Periodically the bulb needs to be emptied and Dr. Miguel Delgado, M.D. wants the patient to keep a log of the amount of fluid removed and its color. This information is important for Dr. Delgado to monitor how the healing is progressing.
The most common drainage is serosanguinous, which is a thin watery substance usually pink to dark red from red blood cells. If the fluid is thick and the color is yellow, green, tan, or brown, it is referred to as purulent exudate and may be an indication of bacteria present in high levels or an infection.
Experience Proves the Advantage of Drains
Some surgeons use drains, and some do not. Dr. Delgado has over 25 years of gynecomastia surgery experience, and he claims that by using drains the incidence of complications is very minimal. If drains are not used it is possible that fluid may collect in the “dead space” and will need to be aspirated and maybe more than once.
For most patients, the drains are removed at the first post-operative visit usually within 4 days. When the tube is removed from the surgery site, you may feel a slight burning sensation, but it only lasts a few seconds.
Stay in Touch With Your Surgeon
Dr. Delgado instructs his patients to notify him if any of the following conditions are noted: • Fever • The color of fluid is brown, yellow, or green • A change in the odor of the fluid • An increase of pain
For any concerns about male breast reduction, call now (415) 898-4161 for an appointment with Dr. Delgado.
Posted on: September 12th, 2017 By: Miguel Delgado
Gynecomastia is caused when excess estrogen gets stored in the male body which then leads to breast development.
Male Breasts May be Asymmetric
Usually, when a man develops gynecomastia, the breasts are relatively equal in shape and size. However, it is not uncommon for one breast to develop and be larger than the other. In rare cases, it is possible for only one breast to develop. Asymmetry causes men to feel even more self-conscious than men with enlargement on both sides.
This 43 year old man had liposuction in 1992 for his gynecomastia with another surgeon but was not satisfied with the results. Dr. Delgado performed revision surgery, consisting of suction-assisted lipectomy and glandular excision of the chest. Total fat extraction was 350cc from the right side and 375cc from the left to correct his asymmetry.
Some asymmetry is normal, but when it becomes very noticeable, it can be the cause of much embarrassment and shame.
Asymmetry is Corrected by Surgery
The only way to correct asymmetry is by surgery with a gynecomastia specialist. The surgery entails liposuction, surgical excision of the breast tissue with the goal of a masculine contoured chest.
Sometimes asymmetry can occur during male breast reduction surgery by unseen complications or lack of skill by the surgeon. A secondary surgery will be necessary for correction, be sure to choose your surgeon carefully! The patient will need to wait about 6 months before revision surgery can take place.
Dr. Delgado’s Revision Surgery on the Rise
Dr. Miguel Delgado, M.D. states that about 40% of his gynecomastia practice is made up of revision surgery where patients had their surgery done elsewhere. Most revision cases are correction of too much tissue removed (crater deformity) or not enough tissue removed, along with asymmetry.
If you have had unsatisfactory gynecomastia surgery or hope to avoid revision surgery, call now (415) 898-4161 for an appointment with Dr. Delgado who has been performing male breast reduction surgery since 1988.
Anticipating gynecomastia surgery may cause anxiety for many men. Not knowing what to surgery results to expect can cause further stress. The expert gynecomastia surgeon’s goal is to achieve a natural looking male chest with masculine contours. If the surgeon removes too much breast tissue, the result could be what is known as a “crater deformity,” and if not enough tissues is removed, more surgery may be needed. It is important to select an expert gynecomastia surgeon so you can get it right the first time!
Compression Vest and Drains
After surgery, you will be placed in a compression vest and have drains in place that remove excess fluid and keep swelling under control. The drains are generally removed within 2 to 3 days at the first post-operative visit. Sutures are taken out after 1 week. The vest is to be worn 24/7 for 5 or 6 weeks and only removed when showering. Showering is allowed a couple of days after the drains are removed, and the drain incisions have completely closed. When removing the vest, men need to realize that they are not seeing the final result. There will be swelling and bruising, and the incision at the bottom of the areola will be evident. However, bruising will completely subside in about a week to 10 days; swelling may last several weeks.
Incisions Well Hidden
As the incision around the areola heals, it will be almost undetectable due to the change of skin texture. The small incision from the drain at the side of the chest may leave a scar. Sensitive to men’s comments about this, Dr. Miguel Delgado, M.D. now places the drain incision high up in the armpit and toward the back, most men cannot find it after it heals.
It is not unusual for the swelling to take several weeks to completely resolve. Some swelling is normal as it increases blood supply to the injured area bringing nutrients that aid in healing. However, any unusual swelling needs to be monitored for a possible hematoma (abnormal bleeding outside blood vessels.)
Going Shirtless Becomes a Reality
As the swelling subsides, the final contour of the chest will become evident, and the ability to go shirtless will become a reality!
Unfortunately, for some men, once all the swelling has diminished they may have what is referred to as “puffy nipples.” The cause for puffy nipples is when the surgeon has not removed enough breast tissue that is behind the areola, and the tissue pushes the nipple outward. This condition can be fixed but requires additional surgery. Choose your surgeon carefully!
Gynecomastia patients are encouraged to call now (415) 898-4161 for a confidential consultation with Dr. Delgado.
To schedule a free consultation with Dr. Delgado in San Francisco, California or Novato in Marin County call 415-898-4161. 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 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.
Please feel free to fill out the form below for a price quote or to contact us with any questions or comments you may have.
Dr. Delgado has offices in Marin and San Francisco for your convenience
450 Sutter Street Suite 2433 San Francisco, California 94108 (415) 989-2221