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Body Dysmorphic Disorder and Gynecomastia

Posted on: August 21st, 2018
Posted by Dr. Miguel Delgado

Body dysmorphic disorder

Body dysmorphic disorder (BDD) is an obsessive-compulsive disorder. BDD is where someone cannot stop thinking about what they perceive as a flaw or defect in their appearance. This flaw appears to others as very minor or non-existent.

People with BDD can’t control their negative thoughts which can cause severe emotional distress. The distress may impact their ability to function in their daily life. They tend to obsess for hours a day which may interfere with school or work. Many will avoid social situations, and they may become very isolated.

Body Dysmorphic Disorder Affects Both Men and Women Almost Equally

Most often BDD develops in the adolescent years and early teens. It affects men and women almost equally. BDD sufferers may focus on any part of their body.  Most commonly they focus on their hair, nose, skin, stomach, or their chest.

 BDD may be caused by both environmental and biological factors. Possibly malfunctioning serotonin in the brain, genetic predisposition. Life experiences such as child abuse, or bullying could be to blame for BDD.

Cosmetic Surgery May be Addictive for BDD Sufferers

Some sufferers will attempt to hide their compulsive behavior by camouflaging their flaw with clothing or avoid mirrors. Engaging in excessive grooming, or intense exercise can be a symptom. Others will turn to multiple cosmetic surgeries looking for perfection.

Young men who are going through puberty and develop gynecomastia may experience extreme shame which can lead to low self-esteem. When left unchecked the adolescent boy may find focusing on schoolwork difficult, even failing classes. Interaction with classmates and teachers comes to a halt.

Board certified plastic surgeons are trained to be on the lookout for patients with unrealistic expectations versus patients with a healthy perception of what results they can expect. There is a big difference between low self-esteem and BDD for the gynecomastia patient. For those who are experiencing low self-esteem, corrective male breast reduction surgery can be a life-changing event. For moobs patients with BDD, the expectations of their surgery results will never be met. They will continue to see imperfections, most of which are imagined. It is essential for man boob patients having surgery to have realistic expectations. They need to understand that cosmetic plastic surgery can make tremendous improvements, but will never be perfect.

Moob Surgery or Therapy?

It is the skilled gynecomastia specialist who can communicate with patients to determine if the patient will benefit from surgery or if the patient needs to be managed by cognitive behavioral therapy and perhaps medication.

Call Now!

Call today for a private consultation with Dr. Miguel Delgado, M.D. (415) 898-4161 for any gynecomastia concerns. Dr. Delgado advises patients who think they may have BDD to consult with their healthcare provider.


Estrogen is in Your Food!

Posted on: August 6th, 2018
Posted by Dr. Miguel Delgado

Estrogen in Food Causes Moobs

                                         Before and After Male Breast Reduction Surgery

Men’s body naturally produces estrogen, the “female hormone,” but in a much smaller amount than for women. When estrogen and testosterone are perfectly balanced, the body works as it should. However, Dr. Miguel Delgado, M.D. warns that several factors can unbalance the ratio of hormones that will lead to unwanted side effects such as infertility, erectile dysfunction, and gynecomastia.

Change Your Eating Habits

It is possible for men to lower their estrogen levels by changing their eating habits. If caught early, by avoiding some foods that are high in estrogen, they may be able to reverse some feminine characteristics they may develop before they become permanent.

Estrogen Rich Foods to Avoid

Soy – known as phytoestrogens (plant produced estrogen). This includes soy milk, protein drinks, protein powder, and in thousands of packaged foods. Read the labels! Most grocery store foods that contain soy are genetically modified (GMO). More than 90% of soy grown in the United States is (GMO). However, the traditional crop grown in Japan is not GMO. Miso, natto, and tempeh are fermented soy products and are the safe for consumption.
Sugar and Carbohydrates – Both are highly processed, and in addition to the adverse health effects, they cause the body to produce more estrogen.
Conventional Meat and Dairy – Milk may contain up to 20 medications and growth hormones. Growth hormones are given to cows so that they will produce more milk and grow faster. Look for milk that is organic or labeled “bGH-free.”

Beware of BPA!

When cleaning up your diet, you should also be aware of Bisphenol A (BPA). BPA has been around since the 1960’s and is an industrial chemical often used in the production of plastic water bottles and food containers. BPA mimics the hormone estrogen. Research has shown BPA can leach into beverages or food and cause health issues. Avoid water bottles that have been exposed to heat and foods that are microwaved in plastic containers.

Detox Your Body

You can start to detox your body by avoiding the listed foods and products and add cruciferous vegetables like cauliflower, broccoli, cabbage, Brussel sprouts, kale, etc. You can also increase your probiotic and prebiotic consumption through supplements or fermented foods like sauerkraut, kombucha, and kimchi.

Call Now!

If your breasts are starting to feel tender or painful do not wait, call (415) 898-4161 for an appointment with Dr. Miguel Delgado, M.D.


Moob Surgery and Reasonable Expectations

Posted on: July 25th, 2018
Posted by Dr. Miguel Delgado

unilateral moob in San Francisco

22 year old male presents for unilateral right gynecomastia. Hormone testing proved normal. He had gland excision on the right with liposuction. He is seen here 4 weeks post op.

 

No one has a perfect body, most men carry some extra weight, some are barrel-chested, or some may have a somewhat concave chest. Like women, a lot of men may have one breast larger than the other. It is unknown why some people have more of a propensity to form scar tissue than others. All of these factors can contribute to moob surgery results.

Moob Surgery Complications are Rare

Complications are infrequent, but when they do occur they usually are minor, and most can be treated as an office procedure. However, all surgeries come with some risk such as:

• Bleeding (hematoma)
• Blood clots
• Infection
• Adverse reaction to anesthesia

Specifically for gynecomastia, there can be pigment changes, some asymmetry of the breasts or nipples, loss of sensation or numbness in the nipples which is possible to last up until a year, rarely is it permanent.

Under or Over Resection

Men who are seeking gynecomastia revision surgery usually have not had enough tissue and/or fat removed; this is referred to as “under resection.” Under resection is a common outcome when the surgeon only uses liposuction for moob reduction. Another complication is “over resection” where too much fat and tissue has been removed, also known as a “crater deformity.”

In some instances, men complain that a few weeks after surgery they have “puffy nipples” for most, this is due to the development of scar tissue which generally takes a few weeks to develop. Many times the scar tissue can be resolved with steroid injections done in the office.

Common Conditions After Moob Surgery

Dr. Miguel Delgado, M.D. states that after the trauma of surgery, moob patients will find that there will be swelling, and bruising, but when, where, and how much can’t be determined. Additionally, scar tissue will form, but again how much can’t be predicted.

After obsessing about their man boobs for a long time, some men will be looking for perfection. Plastic surgery is not a perfect art; however, significant improvement can be expected.

Find an Experienced Moob Surgeon

In the hands of an experienced board certified plastic surgeon that specializes in gynecomastia, many steps can be taken to assure a great outcome. A general surgeon and even some board certified plastic surgeons do not have the skills that a gynecomastia specialist has for a very complex surgery.

It is the expert gynecomastia surgeon who understands possible complications and how to treat them.  This is the surgeon who does 100’s of male breast reductions surgeries a year, not just a few. View many before and after pictures and select a surgeon with impressive results.

Call Now!

Dr. Delgado has 100’s of before and after pictures available for viewing, call today (415) 898-4161 for a consultation.

 


Gynecomastia Do’s and Don’ts

Posted on: June 18th, 2018
Posted by Dr. Miguel Delgado

Gynecomastia before and after in San Francisco

                                                 Before and After Gynecomastia Surgery

Gynecomastia or male breasts can be an extremely humiliating condition for men. Many men will go to great lengths to be rid of their man boobs.

• Over the Counter Products

We have yet to hear of any product that you can buy that will reduce men’s boobs. The most advertised come in pill form and the only thing that gets reduced will be your wallet. Check the forums on gynecomastia.org and read many comments by men who have tried them.

• Diet and Exercise

Diet and exercise are always recommended but not as a way to reduce male breasts. Unless you have pseudo-gynecomastia (breasts caused by fat only)diet and exercise will not reduce breast tissue. Fat may be reduced but the remaining breast tissue will look even more prominent.

• Taking Hormones

Hormone imbalance is the major cause of breast growth for men. Some men believe if they increase their testosterone level it will reduce their man boobs. This is a big misconception; it can actually increase breast growth as the additional testosterone may get converted into estrogen. Messing with your hormone levels is very risky.

• Compression Vests and Layering of Shirts

For some men they will try to hide their chest by wearing several layers of shirts or wear a compression vest. This may work for some, but the bulkiness will be quite uncomfortable after a time and too hot in the warmer seasons.

• Gaining Weight

In an effort to hide man boobs, some have tried to gain weight with the idea that the breasts won’t be as obvious. This is not a good idea, as the breasts which contain fat cells, will grow bigger as well.

  • Recommendation

What is recommended is for you to consult with a gynecomastia specialist. Most people today know that they should consult with board certified doctors, but in the case of man boobs, you need to go a step further. In addition to being board certified, you want a surgeon who specializes in gynecomastia and has done hundreds of cases, not just a few a year. Dr. Miguel Delgado, M.D. warns that male breast reduction surgery can be very complex and in the wrong hands you may end up not only dissatisfied but in need of revision surgery. It is best to get it right the first time! When in consultation or even before making an appointment, ask how many cases the doctor does on average each year. View before and after pictures of patients so you can see what type of results you can expect.

Call Today!

For any gynecomastia concerns you may have, call now (415) 898-4161 for an appointment with Dr. Delgado who has specialized in male breast reduction since 1988.


Massage After Gynecomastia Surgery

Posted on: June 11th, 2018
Posted by Dr. Miguel Delgado

Massage for Gynecomastia patients in San Francisco

Scarring can be very unpredictable, and no two patients will heal the same. As the body recovers after gynecomastia surgery, there will be scar tissue forming both internally and externally. Sometimes the scar tissue may feel lumpy, and some men are fearful their man boobs are returning. This scar tissue is not breast tissue and will not affect the overall appearance.

Scar Tissue After Gynecomastia Surgery

Scar tissue will not disappear if it is massaged, but there are benefits to be gained, Dr. Miguel Delgado, M.D.  has his patients start a gentle massage after about 3 weeks as long as it is not painful. To start massaging before then may cause unwanted swelling.

 

The Benefits of Massage

The skin may feel hypersensitive as healing takes place and sensation starts to return. Massage may reduce the sensitivity. In addition, massaging can help the body get rid of pockets of fluid and reduce swelling. Massage may help internal scarring to be looser and more flexible. Massaging external scars with a lubricant may prevent scars from cracking and drying out.

How to Massage

If you are instructed to start massaging, the way to do it is; raise one arm over your head, take the three middle fingers of the opposite hand and gently use a circular motion on areas that feel firm. Gradually increase the intensity, but not to the point that it hurts. Massage for about 5 minutes on each side two times a day.

Options for Scar Revision

It isn’t possible to avoid scar formation after surgical procedures. However, there are treatment options available to reduce scar tissue such as; steroid injections, or even a minor scar revision surgery.

Do not attempt massaging your chest unless directed by your surgeon.

Call Now!

For additional information for any gynecomastia concerns, call today (415) 898-4161 for an appointment with Dr. Miguel Delgado, M.D.

 


Gynecomastia Surgery, Is it Necessary?

Posted on: May 25th, 2018
Posted by Dr. Miguel Delgado

Gynecomastia Specialist, Miguel Delgado, M.D.

                                          Before and After Gynecomastia Surgery

Gynecomastia is noncancerous enlarged breast tissue in men. Male breasts can develop when there is a hormonal imbalance of estrogen to testosterone. 65%  of men or more will develop breasts at some point in their life; it is often seen in newborn male babies, as boys go through puberty, and in the aging male. In most cases, the male chest will return to normal on its own within a few weeks to a few months.

Gynecomastia From Mild to Severe

There are 4 grades of gynecomastia, from mild to severe. After puberty, if the male breast has not returned to normal after 2 years, then surgery will be the only permanent solution.

Some men are comfortable with their breasts and do not feel the need to hide them. They are able to have a normal life without their breasts causing them any embarrassment. They enjoy the beach and pool parties or any situation where they remove their shirt. For these men, they do not need to consider surgery as the breast tissue is benign.

Male Breast Cancer is Rare

Gynecomastia has been known to be caused by certain medications used in the treatment for such conditions as; ulcers, prostate cancer, and heart conditions. However, even though gynecomastia is fairly common, male breast cancer is rare. There are only about 2,000 men a year diagnosed with breast cancer, and of that number about 400 die of the disease. Men with gynecomastia are slightly more at risk for breast cancer due to the elevations of estrogen. Additionally, men are more at risk for breast cancer if it is in their family history, Jewish ancestry, or some genetic disorders.

Dr. Miguel Delgado, M.D. states that even though the incidence of cancer is very low, men should get regular checkups, do self-breast exams, and always be on alert for any lumps, unusual swelling, or pain and see their doctor promptly.

Schedule a consultation now with Dr. Delgado (415) 898-4161 for any gynecomastia concerns.


Gynecomastia Surgery for Out of Town Patients

Posted on: May 11th, 2018
Posted by Dr. Miguel Delgado

In general, patients choose their cosmetic plastic surgeon close to home for convenience and for easier follow-up care. For the most part, there are excellent board certified plastic surgeons in all parts of the United States. However, there is an exception to this, for some specialties such as gynecomastia, finding an expert may involve travel.

Gynecomastia Specialist for Surgery

Many surgeons will perform male breast reduction, but if they are less experienced, the results may lead to necessary revision surgery. It is better to get it right the first time; it will be less expensive, time-consuming, and better results.

It is essential for men to do their homework in researching the surgeon of their choice. Be sure to review many before and after pictures, read reviews, and make sure the surgeon is board certified in plastic surgery. Go on two or three or more consultations until you feel comfortable with the surgeon and the staff.

Gynecomastia, before and after

                                                       Before and After Gynecomastia Surgery

Surgical Excision and Liposuction Needed

Gynecomastia.org is a wonderful informational website dedicated to men searching for answers to many questions they may have about their male breasts. There are gynecomastia specialists on the forums along with the members who will answer questions and share stories. Be sure you understand that “true gynecomastia” involves both surgical excision and liposuction to get the best results. Do not opt for liposuction alone unless what you have is “pseudogynecomastia.” Pseudogynecomastia means only fat is causing your male breasts.

Dr. Miguel Delgado, M.D. states that over 40% of his practice is gynecomastia revision surgery where other surgeons did not remove enough tissue, or they removed too much. Don’t let this happen to you!

Men Travel From Afar to See Dr. Delgado

Dr. Delgado’s reputation as a gynecomastia specialist is nationwide and beyond. Men travel from all over the United States and other countries to be treated by him. Dr. Delgado appreciates that men are willing to travel far distances to see him, so he has implemented many protocols to assist his out of town patients.

Dr. Delgado offers a complimentary consultation either by Skype, or phone, after a patient sends pictures. After the consultation, the patient will be provided with a detailed quote. If the patient decides to come to Novato for surgery, a surgery date will be set, and a comprehensive booklet will be sent giving the patient pre and post-operative instructions.

Special Rates for Out of Towners

                                                                                                                                                                     Novato Oaks Inn                                                                                                                                                                                                                                                                                                                   The patient needs to arrive a couple of days before surgery for a pre-operative visit.  Dr. Delgado has arranged a special rate for out of town patients at the Novato Oaks Inn, be sure to mention his name when making reservations. The hotel is nearby and offers a free shuttle to the office.

Patients need to plan on staying a week after surgery for their follow up care, including drain and suture removal. Once home, Dr. Delgado will keep in touch by phone or Skype to follow your recovery.

Make an Appointment Today!

Contact us now to get your free virtual consultation with Dr. Delgado. For your complimentary consultation, email the following information to us at info@dr-delgado.com:

  • Your name
  • Age, weight, height
  • Upload pictures of your chest, front and profile
  • Your phone number and when we can contact you

 


Gynecomastia Surgery, Sometimes a Two-Stage Procedure

Posted on: April 20th, 2018
Posted by Dr. Miguel Delgado

 

For men with moderate to severe gynecomastia, a different approach for male breast reduction surgery is required. Older men who have lost elasticity of their skin or have had a massive weight loss of 100 to 200 pounds may have a tremendous amount of loose skin. Some surgeons will opt for a mastectomy type surgery where removal is done in one procedure. However, Dr. Miguel Delgado, M.D. tries to avoid this as he feels the resulting scar that goes across the chest is almost as disturbing as the large breasts

Gynecomastia Specialist, Dr. Miguel Delgado

A gynecomastia specialist, Dr. Delgado has been performing gynecomastia surgery since 1988. Dr. Delgado believes the way to get the best surgical result for a man with severe gynecomastia is to do male breast reduction surgery in two stages.

Stage One

The first stage is done with aggressive excision of the breast tissue along with liposuction. If the patient doesn’t have a lot of loose skin, a crescent lift may be done. A crescent lift is where a half donut shaped piece of skin is excised above the areola that reduces sagging and the lower fold. For some patients, the result is such that they may choose not to have a secondary procedure, but the scar will be  more visible at the top of the areola.

gynecomastia first stage

Extreme Gynecomastia

For more severe cases such as the one pictured here, a secondary procedure is scheduled after four to six months after the first stage.

Stage Two

Gynecomastia, First Stage After 6 months

Six Months After First Stage

The secondary procedure is the periareolar lift. The periareolar lift removes a donut of skin completely around the areola. After healing, the incision will blend into the areola extremely well.

Post Op at Two Weeks

gynecomastia two weeks after second stage

Two weeks after second stage

Call now (415) 898-4161 for a gynecomastia consultation with Dr. Delgado.


Scar Tissue After Gynecomastia Surgery

Posted on: April 9th, 2018
Posted by Dr. Miguel Delgado

Scar tissue After Gynecomastia surgery in San Francisco

Before and After Gynecomastia Surgery

Two really excellent sources in getting feedback from gynecomastia patients are the websites; Gynecomastia.org and RealSelf.com. One concern, which comes up from time to time on both sites, is men who state that after a few weeks their gynecomastia has come back.

Scar Tissue Feels Like Breast Tissue

Recurrence of breast tissue is an alarming situation for men who have invested in their male breast reduction, only to have it come back. As long as the patient has not resumed in taking medications, steroids, or other known causes of gynecomastia, it most likely is not regrowth of breast tissue. If the original outcome of surgery was a nice sculpted chest, the recurrence of puffy nipples or the feel of breast tissue under the skin is most likely the formation of scar tissue. Scar tissue can form any time after surgery, usually within 4 to 12 weeks.

Puffiness May Be Swelling

If there is puffiness right after surgery it could be swelling or possibly not enough breast tissue was removed, but it would not be caused by scar tissue.

Men are encouraged not to panic but to talk to their surgeon about their concerns. The formation of scar tissue most likely will not require surgical intervention. Most of the time, the scar tissue will resolve on its own. However, after recovery, the surgeon can give injections of steroids such as Kenalog. Over time the steroid may dissolve the scar tissue.

Choose Your Surgeon Carefully

It is imperative to choose your gynecomastia surgeon carefully. Many surgeons are concerned about removing too much tissue and creating a “crater deformity,” or they are over cautious and do not remove enough. In either case, gynecomastia revision surgery will be necessary. With the addition of scar tissue from the original surgery, you will need the expertise of a gynecomastia specialist.

Call Now!

Dr. Miguel Delgado, M.D. states that more than 40% of his gynecomastia practice is revision surgery.  Under resection or over resection is the primary cause for revision surgery. If you are having any issues with gynecomastia, call today (415) 898-4161 for a consultation with Dr. Delgado.

 


Dr. Delgado Talks About Drains and Compression Vests

Posted on: March 23rd, 2018
Posted by Dr. Miguel Delgado

 

Dr. Delgado, a specialist in gynecomastia has been performing male breast reduction since 1989. Considered one of the top gynecomastia surgeons in all of the United States he has patients who travel from all parts of the United States and other countries to be treated by him.

Dr. Delgado is a Leader in Gynecomastia

Dr. Delgado provides the latest in technology and technique to his patients, many of which he designs himself. The result is a high satisfaction rate he receives from his patients. In the before and after pictures below is a delighted patient who wanted to share his own photos.

Dr. Delgado has a happy patient

In listening to his patients, Dr. Miguel Delgado,M.D. learned that the tiny scar left by the incision made for the drain was quite bothersome to many patients. Dr. Delgado explains in detail the need for drains; you can read more about that in the blog dated September 2017. Note in the after picture below where you can see the small scar right below the armpit.

Scar from drain before new technique

 

By moving the incision high up into the armpit, once it has healed patients have a hard time locating it!

Patient Comfort is Key

Another innovation by Dr. Delgado is the design of his unique compression vests. Previously commercial vests were bulky and did not have a provision for the awkward drain bulbs. Before, the bulbs were attached to the vest with a safety pin as shown in the picture.

Dr. Delgado vest

Dr. Delgado designed his vest with removable pockets that hold the bulbs. Once the drains were removed, the pockets came off making the vest less bulky. Also, the shoulder straps are adjustable allowing for more comfort. Then there is a second stage vest that is used when healing has progressed. The second vest is made of thinner material and has compression over the chest only. Lined with a soft T-shirt fabric, the vest is even more comfortable and undetectable under most shirts.

Call Today!

Are you ready to address your gynecomastia concerns? Call now(415) 898-4161 for an appointment with Dr. Delgado; you will be glad you did!

 


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