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:
• 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.
Posted on: August 30th, 2017
By: Miguel Delgado
Gynecomastia Surgery Results
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.
Posted on: August 11th, 2017
By: Miguel Delgado
Parabens have been used to prevent bacterial growth and as a preservative for many cosmetics and some foods since the 1950’s. They are cheap and stable and were believed to be safe until late in the 1990’s when it was discovered that there were some negative reactions.
Parabens Mimic Estrogen
Parabens have been deemed xenoestrogens, which mean they mimic estrogen. If parabens can be stored in the body, there is concern about the cumulative effect and possible health risks. However, to date, there is no scientific evidence to support any link with cancer. To identify parabens read all labels, note anything that ends in paraben, such as:
This is an 18-year-old man with significant gynecomastia who presents for gland excision and liposuction. His goal is to have a normal appearing chest. He underwent breast gland excision and liposuction. In addition, he had a superior incision for a crescent areola lift for superior advancement of the areola tissue.
Some men with high paraben concentrations may have lower muscle mass and more body fat and possibly have developed breasts. Japan has been doing research that showed there was damage to reproductive systems for some men and they had a lower sperm count along with lower levels of testosterone. Adding to these disturbing discoveries was the fact that damage was seen at doses lower than what is considered the acceptable daily intake.
Parabens in Food Banned in Europe
Europe outlawed the use of parabens in food in 2006, but in the United States, it is still used in many snack items. It is recommended that if you want to avoid them, read labels carefully and try to avoid processed foods and packaged pastries. Dr. Miguel Delgado, M.D. warns patients that what you put on your skin is as important as what you put in your mouth. Many products such as shampoos, lotions, deodorants, cosmetics, etc. have parabens in them.
Schedule an Appointment Today!
Men suffering from male breasts are invited to call now (415) 898-4161 for a consultation with gynecomastia expert, Dr. Delgado.
Posted on: July 27th, 2017
By: Miguel Delgado
Gynecomastia is Worldwide
Gynecomastia is a common condition that affects a large percentage of men worldwide. India, in particular, has shown great interest in gynecomastia and it is reflected in the many inquiries from Indian men on such websites as Gynecomastia.org.
Dr. Delgado Explains the Struggle With Moobs
The Deccan Chronicle is the largest circulated English newspaper in South India. Recently the Deccan Chronicle picked up a story that was published in Daily Mail Online on: “My Struggle With Moobs’: Inside the Booming Industry of ‘Man Boob’ Reconstruction Surgery.
The interview with Daily Mail Online gives a comprehensive outline on causes and solutions as presented by San Francisco Board Certified Plastic Surgeon, Dr. Miguel Delgado, M.D. a specialist in gynecomastia.
Steroids and Puberty Set the Stage
Man Boobs or gynecomastia is the development of female type breasts on a man. The major cause is in young men as they go through puberty, however, for the majority, it will resolve on its own. The second major cause is bodybuilders or athletes who use steroids. Once the breast tissue starts to grow the only solution will be surgery.
Dr. Delgado explains the simpler cases and also the more extreme cases that may need to be done in stages. This is not a “one size fits all” type surgery, but it is very individual with precise planning for each case. The patient below is an example of extreme gynecomastia.
Preoperative, patient with severe gynecomastia
6 months after first stage; gland excision, liposuction, superior crescent lift, and external lift sutures.
2 weeks after second stage; peri-areolar lift with donut shape skin excision
Whether you live near or far, call (415) 898-4161 for an in-person consultation, or if you are out of town or out of the country you may Skype, email or have a phone consultation with Dr. Delgado.
Posted on: July 13th, 2017
By: Miguel Delgado
Dr. Miguel Delgado, M.D. is not only an expert gynecomastia surgeon; he is now an expert in the production of fine wine! More than 10 years ago the Delgado family acquired a vineyard in Sonoma Valley. The wines produced at that time were good, but good isn’t good enough for Dr. Delgado who is a perfectionist in every way! The Delgado’s hard work paid off with double gold awards for their wines at the 2017 Wine Competition sponsored by the San Francisco Chronicle.
Competition Included Thousands of Wines
The San Francisco Chronicle’s Wine competition is considered the largest competition in the world for American wines. This year marks the Chronicle’s wine event with over 7,000 entrants, and 28 states were represented.
The judging panels are from different major wine locales which give diversity for the selection of just a few exclusive wines from the thousands of participants.
The wine competition, which has been a favorite Bay Area event for years, is open to the public for wine tasting paired with tasty appetizers.
Delgado’s Wines Win Double Gold and Outstanding Rating in Points!
This year Dr. Delgado entered both his 2014 Pinot Noir, and his 2014 Chardonnay with amazing results! Both wines were awarded Double Gold medals!!
In addition to this honor, Wine Enthusiast Magazine rated the Delgado Family Vineyard’s Pinot Noir 2014 90 points and the 2014 Chardonnay 92 points!!
The point system is a way of rating wines as follows:
• 95 to 100 points: Classic
• 90 to 94 points: Outstanding
• 85 to 89 points: Very good
• 80 to 84 points: Good
• 75 to 79 points: Mediocre
• 50 to 74 points: Not recommended
Buy Today Before They are Sold Out!
The award winning chardonnay is priced at $30 a bottle, and the award winning Pinot Noir is priced at $32 a bottle. Don’t miss out! There is a limited production of 3 barrels of each wine, shop now at https://delgadofamilyvineyard.com/wines/ while these premium wines are still available.
Posted on: June 29th, 2017
By: Miguel Delgado
Be Patient, Swelling Takes Weeks to Resolve
Recovery from gynecomastia surgery, like most surgeries, will go through several stages. You will experience bruising and swelling. The bruising may be minimal, or for some, it can be quite extensive, healing can take 2 to 3 weeks.
Swelling is normal with most of it subsiding in a few weeks but may take several months for all of it to resolve. However, severe swelling can be the sign of something more serious such as a hematoma. A hematoma is bleeding under the skin. A very low percentage of Dr. Delgado’s patients experience this complication due to his advanced surgical techniques.
Drains and Sutures
Drains will be placed at the end of your surgical procedure to remove fluid that accumulates naturally. The drains will be removed at the first post-operative visit, usually within 2 to 3 days. Additionally, sutures are removed after 1 week.
After surgery, Dr. Delgado has his patients placed in a compression vest to be worn for 6 weeks and emphasizes there is to be no strenuous exertion or formal exercise for 4 to 6 weeks.
Protect Gynecomastia Scars From the Sun
Patients are warned to keep their chest out of the sun for several months. The sun can cause hyper-pigmentation on fresh scars turning them permanently dark. Once a scar is no longer pink sun exposure should be safe, but the use of sun block is recommended.
Gynecomastia patients may have a temporary decrease in the sensation of the nipple-areola complex, for most patients it is insignificant, but for some, it may take a year for full sensation to return. Massage is recommended to reduce hypersensitivity of the skin as sensation returns.
Blood Thinners Must be Avoided!
Dr. Miguel Delgado, M.D. warns patients to continue to avoid all blood thinners for at least 2 weeks after their surgery because it is possible to still have a bleeding issue. In addition, he advises his patients to follow a healthy diet for a faster recovery.
Schedule a gynecomastia consultation today (415) 898-4161 with Dr. Delgado to address any male breast issues you have.
Posted on: June 15th, 2017
By: Miguel Delgado
Treatment for body builders with gynecomastia is usually different than for other men. Body builders usually do not have excess fat or skin. Body builders may be at higher risk for bleeding complications due to highly developed chest muscles that allow an increase in blood flow. Fish oil, certain vitamins and some protein shakes contain blood thinners that need to be stopped before surgery as they can increase the risk of bleeding.
Body Builders May Develop Breasts
Not all body builders will develop gynecomastia; there is no way to determine who will. However, if as young men they had adolescent gynecomastia, they are at greater risk.
Anabolic steroids continue to be popular with many men wanting to build muscle mass, but they find that they may start to develop breasts due to the high content of estrogen; some men can even begin to lactate. Other side effects of taking steroids include, painful erections, shrinking of testicles, decrease in sperm count, infertility and impotence. Anabolic steroids require a doctor’s prescription for a medical condition. Doctors are not allowed to prescribe steroids to enhance athletic performance.
Estrogen Blockers Bought on the Black Market
Many iron pumping weightlifters take the breast cancer drug Nolvadex, which is the generic form of Tamoxifen, which is used to counteract the continued use of steroids. Nolvadex is an estrogen inhibitor but requires a prescription and is used for the treatment of breast cancer. Social media such as Facebook has become a source for finding black market prescription drugs. However, there are many side effects associated with the drug such as; nausea, vomiting, hot flashes, numbness, blurred vision, leg cramps, thinning hair, reduced sexual interest, impotence, skin rash, risk of blood clots, cataracts, and depression.
Sadly many men will do whatever it takes to be bigger and stronger even if it shortens their life span.
Stop Steroids to Stop Breast Growth
Many body builders want to have all of their breast tissue removed so that they can continue to take steroids and avoid recurrence of breast tissue growth. However, Dr. Miguel Delgado, M.D. states that some breast tissue needs to remain for contouring or the chest will have an unnatural appearance. Dr. Delgado encourages men to discontinue the use of steroids and estrogen inhibitors and enjoy the natural look of their chest after male breast reduction surgery.
Call today (415) 898-4161 for a gynecomastia consultation if you are unhappy with your chest.
Posted on: May 24th, 2017
By: Miguel Delgado
Gynecomastia sufferers ask Dr. Miguel Delgado, M.D. “will smoking marijuana cause gynecomastia?” Another popular question is, “If after male breast reduction surgery if I smoke cannabis, will my man boobs come back?”
Do Doobies Make Boobies?
There are many different causes of male breast enlargement. A primary cause is puberty, when a young man goes through hormonal changes; also obesity, steroid use, and aging are known causes. Each patient is unique and what may trigger breast growth in one man might not for another.
There is not any conclusive evidence that marijuana contributes to gynecomastia, but there are many patients and physicians that believe it is so.
Medical Daily quotes Marijuana.com saying “Doobies Make Boobies,” but not for women. Animal studies show exposure to delta-9-tetrahydrocannabinol known as THC (the active ingredient in weed) decreases testosterone levels, however, human studies remain inconclusive. There are many conflicting reports that lead to a lot of confusion.
Gynecomastia Surgery Increases 5%
The Mayo Clinic lists marijuana along with amphetamines, alcohol, heroin, and methadone as potential causes of male breasts. Additionally, on the list of causes, there are herbal products and many medications.
Robert Murphy, Jr., president of the American Society of Plastic Surgeons, believes there is a correlation with the 5% increase in gynecomastia cases last year and the acceptance and easier access to marijuana in the United States.
With the link between gynecomastia and cannabis highly probable, you must ask yourself if after having male breast reduction surgery “is the high worth it?”
Call for a Consultation Today!
Call Dr. Delgado (415) 898-4161 now if you are having any concerns about your male breasts.
Posted on: May 12th, 2017
By: Miguel Delgado
Determining the Cause for Gynecomastia
It is recommended that men who have enlarged or swollen breasts see a doctor for an evaluation. If gynecomastia is the diagnosis, most cases are benign and can be left untreated unless it is embarrassing and causes emotional stress, in which case surgery may be recommended.
Your doctor will ask many questions to find out what may have caused breast enlargement such as:
• When did your breast first become swollen?
• Do you drink alcohol? How much?
• Do you take prescriptions drugs? Illegal drugs?
• Do you take any supplements or steroids?
Additionally, the doctor will want to know if you have any of the following:
• Do you have any relatives with breast cancer?
• Klinefelter’s Syndrome?
• Hodgkin’s Lymphoma
• Estrogen therapy for prostate cancer?
Too Much Estrogen May Produce Breasts
Males have both male and female hormones with the male hormone more dominate. If something is blocking or reducing the male hormone, testosterone, it will make the female hormone, estrogen more dominate, possibly allowing the development of breasts.
If the doctor can’t determine the cause of gynecomastia, it may be recommended that the patient sees an endocrinologist for further testing.
Breast cancer in men is very rare, but it does occur so any unusual changes in either breast should be checked out.
What to Watch For
Some concerning symptoms that you should see a doctor about immediately would be:
• A mass that is fast growing on one side of the chest
• A bloody or milky discharge from the nipple
• Changes of the skin on the breast
The risk for men in getting breast cancer is about 1 in 1,000 and mostly for men between the ages of 60 and 70. African American men seem to be at a higher risk than Caucasian men.
Breast cancer in men can be more serious than for women because it usually is not detected as early and the cancer may have already spread to the lymph nodes.
Do Not Wait if You Have Symptoms
Dr. Miguel Delgado advises men if they have any unusual symptoms to seek medical attention right away. Call now (415) 898-4161 for a consultation with Dr. Delgado to discuss any issues or questions you may have about your breasts.