Posted on: August 12th, 2016
By: Miguel Delgado
For men who have hidden the embarrassing condition of female type breasts, making an appointment to see a gynecomastia specialist is a big first step. It is understandable for gynecomastia patients to be anxious and therefore, Miguel Delgado, M.D. recommends writing down all questions as it is easy to forget what you want to ask. However, Dr. Delgado wants his patients to know that he is easily accessible and encourages his patients to call (415) 898-4161 anytime they have a question.
The following questions are some you may want to consider:
1. Is your gynecomastia specialist board certified?
2. Is the anesthesiologist board certified?
3. What type of anesthesia is used?
4. If surgery is to be done at a surgery center, is it accredited?
5. How many years has your specialist been performing male breast reduction, and how many each year?
6. What caused my gynecomastia?
7. How long will my male breast reduction last, and will it come back?
8. How would my surgery be done?
9. Will liposuction alone work for me?
10. Where will the incisions be? Will the scars show?
11. What prescriptions will I need? What are they for?
12. How long after surgery before I can go home?
13. Will I have drains?
14. How long will I need to wear a compression vest?
15. How much time do I need to take off work?
16. When can I start lifting weights?
17. What risks does the surgery have?
18. How are complications handled?
19. Can I see before and after pictures of gynecomastia patients?
20. What is the cost?
Getting answers to all of your questions will ease your anxiety and ensure a positive experience. Dr. Delgado states that the only complaint he has received from his male breast reduction patients is that they wish they had their surgery a long time ago! Start today by calling (415) 898-4161 for your initial consultation!
Posted on: July 31st, 2013
By: Miguel A. Delgado Jr., MD
Miguel A. Delgado, Jr., M.D.
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.
Posted on: May 18th, 2010
By: Miguel A. Delgado Jr., MD
WEBCAM ALLOWS PERSONAL CONSULTATION
We all know the world has gotten smaller with the incredible progresses of technology. We are able to do things unheard of even ten/twenty years ago. The popularity of Skype has opened doors and opportunities for all of us. Dr. Delgado now offers complimentary consultations via Skype for out of town patients which allow them the opportunity to have the next best thing to a personal consultation for male breast reduction. Gynecomastia surgery techniques can vary from patient to patient, depending on the severity of their case. With Skype,Dr. Delgado can evaluate a patient, and answer questions, saving the cost of travel for that initial consutation.
For those who have never experienced Skype, it is easier than you may think. Most computers come with built in web cams, but if your computer doesn’t have one, they are very inexpensive to purchase and will attach right to your computer. Radio Shack has them for $20 and up. Amazon.com has them for less than $10. Less than the cost of a consultation!
Registering for Skype takes only a few minutes, and it is free. So not only do you get to speak directly with Dr. Delgado you will be meeting him face to face, a great opportunity to get to know him. After your consultation, his patient coordinator will be able to email a quote to you. If you are interested in having a consultation this way with Dr. Delgado, please call the office and set up a time. (415) 898-4161.
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.
Posted on: April 30th, 2017
By: Miguel Delgado
Risperdal Lawsuits Climb
Litigation against Johnson and Johnson (J&J) for their drug Risperdal, had the second highest growth rate for 2016, following Xarelto. Xarelto may be reaching a plateau for new lawsuits, but litigation against J&J has no indication of slowing down. In November 2016, there was a 39% increase with over 15,400 pending lawsuits.
Risperdal is an anti-psychotic drug that was approved by the FDA in 1993 for the treatment of schizophrenia and bipolar disorder for adults. In 2007 the drug was approved for use by children. Along with the stated side-effects, the development of breasts known as gynecomastia was significantly understated. Many physicians were unaware of the complication due to inadequate labeling and therefore were not able to warn parents.
Many of the men who used Risperdal chose to have surgery to get rid of their female type breasts. In order to receive compensation for their surgery and emotional trauma, lawsuits were filed.
Plaintiff Awarded $70 Million
As the trials move forward, the most recent victory went to the plaintiff who had been on Risperdal since he was 5 years old. The jury awarded him $70 million. The Philadelphia jury believes J&J failed to have a proper warning on the label to warn men and physicians of the risk of breast development, even though J&J were aware of the side effect for many years.
J&J will continue to defend each case and have no plans to discontinue Risperdal as they feel it is a “safe” drug, and the benefits outweigh the risks. Even with millions of dollars in awards, J&J considers the payouts just the cost of doing business as the drug brings in billions of dollars in sales each year.
Not all verdicts are in favor of the plaintiffs, one such case in March of this year was tossed out when the treating physician claimed she would have prescribed the drug even with a different warning as she felt the benefits outweighed the risks. This is one of three cases that went in favor of the defendant; however, the plaintiffs plan to appeal.
Future Drop in Sales
As consumers become more aware of the gross negligence by J&J regarding their drug Risperdal, they may eventually see a drop in sales.
Dr. Miguel Delgado, M.D. has been treating patients with gynecomastia since 1989 and is an expert in his field. If you are concerned with the development of female type breasts, call today (415) 898-4161 for an appointment with Dr. Delgado for a confidential consultation.
Posted on: February 18th, 2017
By: Miguel Delgado
After significant weight loss, gynecomastia sufferers have an additional issue to deal with. Besides reducing male breasts, there is now redundant, tissue, fat, and skin requiring more contouring and skilled techniques.
2 Stage Gynecomastia Surgery
Some men are candidates for the 2 stage procedure. The first stage removes breast tissue and fat under the skin. The second stage is a minor procedure that can be done in the office under local anesthesia. Excess skin is removed around the areola in a doughnut shape and is closed with a purse-string type sutures.
Before and After Stage One Gynecomastia Surgery
He is seen two weeks after Stage Two Surgery
Massive Weight Loss and Gynecomastia
For men who have had massive weight loss, most will likely not get desired results with the more traditional procedure of removal of fat and tissue with a hidden incision around the areola. Instead, for the more severe cases, the patient may need an incision going around the areola and a vertical incision to the breast crease creating an anchor reduction.
The anchor incision, also known as an inverted T, will leave visible scars. Most patients understand the trade-off and are accepting of the procedure in order to obtain the best breast shape.
Male Chest After Weight Loss
After Gynecomastia Surgery
Many patients find their incisions heal nicely and are comfortable with their results. For others, it is possible they may develop keloid scars which are raised and can be quite noticeable.
Scar Care After Gynecomastia Surgery
Today there are several different treatments available to help with scar management. The experienced board certified gynecomastia specialist will use deep suturing techniques to reduce tension on the skin that helps avoid keloids. Once the incision has healed silicone sheeting is applied, it will help keep the skin hydrated, which helps in scar control.
Additional preventive measures include; steroid injections, scar massage, and laser treatment such as the Palomar Laser. As a last option, scar revision may be done, but that will involve another incision.
Gynecomastia patients are encouraged to call Dr. Miguel Delgado at (415) 898-4161 for a consultation.
Posted on: January 12th, 2017
By: Miguel Delgado
A disappointing result after gynecomastia or male breast reduction surgery is the possible scarring that forms around the areola when the incisions heal. Men faced with unsightly scars feel they have traded one problem for another.
Too Much Collagen Forms Scars
It is not known why some people are more susceptible for scar formation than others. Scars are a natural result of the body healing itself when there has been trauma to the skin. During the healing process, the body produces collagen fibers that will end up having a different texture than the surrounding skin. Sometimes the body will over produce collagen, creating a buildup of tissue, resulting in a firm raised scar known as keloid or hypertrophic scars.
Before and After Scar Treatment
In most cases, it is not medically necessary to remove these benign scars. However, if they are noticeable, they may cause a lot of discomfort to the gynecomastia patient who wants to be able to go shirtless after surgery.
Options for Scar Removal
There are several options available for scar removal including; surgical excision, steroid injections and laser treatment, such as the non-invasive Palomar Icon Fractional Laser.
Having your initial gynecomastia surgery performed by a Board Certified Plastic Surgeon who specializes in gynecomastia, is your best bet for avoiding noticeable scars. Patient participation in preventing unsightly scars is crucial. Be sure to follow your surgeon’s post-operative instructions that should include; avoiding direct sunlight for 6 months to a year. Sunlight is known for contributing to hypertrophic scars. Using silicon sheeting once the incisions have healed have proved to be very beneficial in scar prevention.
Before and After Gynecomastia Surgery
If you are struggling with unsightly scars after gynecomastia surgery, schedule a consultation today (415) 898-4161 with Dr. Miguel Delgado, M.D. to find what options are available to you for removal.
Posted on: December 14th, 2016
By: Miguel Delgado
Puffy Nipples After Corrective Surgery
Many men complain about puffy nipples after healing from gynecomastia surgery. Liposuction is great for fat removal but will not remove the gland effectively.
Gynecomastia Revision Surgery
Dr. Miguel Delgado, M.D.’s gynecomastia practice consists of about 40% revision cases after surgery performed by another surgeon. Removing the correct amount of tissue and fat from the male breast takes the expertise of a board certified plastic surgeon that specializes in gynecomastia. Many surgeons are very conservative in their removal of tissue to avoid creating a crater deformity. However, when too much gland is left behind, it will push the areola out causing “puffy nipples.”
1 Month After Corrective Surgery
Gynecomastia patients that have had male breast reduction surgery and end up with puffy nipples are understandably discouraged because their only recourse is a secondary surgery to remove additional breast gland. This revision surgery is a little more complicated due to scar tissue that has formed from the initial surgery.
Choose Your Surgeon Carefully
It is important to choose your surgeon carefully. First, make sure that he or she is board certified in plastic surgery. Secondly, make sure your surgeon has extensive experience with gynecomastia surgery, taking the right amount of fat and tissue is critical to get the precise sculpting for the chest. If too much is removed a crater deformity will be the result, if not enough gland is removed, you will end up with puffy nipples. In both cases additional surgery will be required for correction, it is much better to get it right the first time.
Help is on the Way!
Call now (415) 898-4161 for a consultation with Dr. Delgado if you are suffering from male breasts or are in need of gynecomastia revision.
Posted on: November 16th, 2016
By: Miguel Delgado
Before and After Gynecomastia Surgery
A big concern for some men considering male breast reduction surgery is “will their breasts grow back?” This is a valid concern as it is difficult enough to decide to have surgery only to have the male breasts come back. In most cases, the results are permanent. However, there are instances that “man boobs” may return.
Not All Tissue and Fat Are Removed
True gynecomastia is treated by surgically removing most of the breast tissue and fat, however, some remains to give a sculpted chest and support the areola. It is the small amount that remains that could be a potential problem in the future.
If surgery is done for a young adolescent, male breasts may return because hormones are still stimulating overgrowth. Body builders know gynecomastia is a risk if they use anabolic steroids and they realize man boobs may return if they continue to use steroids after surgery, some choose to use drugs to block estrogenic effects.
Factors That Cause Man Boobs to Return
Patients who frequently use marijuana may find their male breasts return after surgery if they resume use. Another possible factor for breasts returning is if the patient should gain a lot of weight. Even though the fat cells that were removed won’t come back, the remaining fat cells could become enlarged. Other factors that may cause breasts to return could be certain medications or having a hormonal imbalance. Uncommon, but possible is scar tissue buildup.
To determine the probability of regrowth of breasts, finding the original cause can help in preventing recurrence after surgery. The main cause is puberty; but the breasts usually disappear after the teenage years on their own. Besides puberty, the main reasons for male breast growth are:
• Imbalance of testosterone and estrogen levels
• Decrease in testosterone production, common in older men
• Some medications
• Marijuana and other recreational drugs
• Psychological stress
If any of these conditions can be treated before surgery, it is recommended to do so to prevent regrowth. Unfortunately, the cause of male breasts is not always known; this is referred to as idiopathic gynecomastia.
The good news is that male breasts do not cause any health concerns but do cause a lot of angst for many men, a high percentage will seek surgical correction. Results are almost always long lasting without recurrence, in all the years that Dr. Miguel Delgado, M.D. has been performing gynecomastia surgery, he has seen very few cases where men have had a recurrence. Dr. Delgado recommends that his gynecomastia patients maintain a healthy lifestyle including exercise and good eating habits.
If male breasts are disrupting your life, call Dr. Delgado (415) 898-4161 today for a consultation.
Posted on: October 17th, 2016
By: Miguel Delgado
This is a 27 year old man who underwent gland excision and liposuction at Marin Cosmetic Surgery Center. He had 350cc of fat and aspirate removed from his right side and 400cc from the left. He is seen here 2 months after surgery.
Scottish Men Have Gynecomastia
Cosmetic Surgery for men in Scotland has been booming. In the last decade, the number of men undergoing cosmetic surgery has doubled. One of the most popular procedures is gynecomastia, up 13% from 2014. The majority are young men who work out at a gym. Also, men who have had significant weight loss and have been left with sagging skin, seek this corrective surgery. Scotland’s largest cities have a growing number of clinics making elective surgery more available for their population.
Gynecomastia in Singapore
There is an article in Singapore that has been published about a man named David (not his real name) who had gynecomastia. David’s story is a common one that we hear in the United States. He had been suffering from man boobs since his early 20’s; he tried to pass it off as nothing but he had physical discomfort in his chest that he could no longer ignore. He thought he might have heart problems, so he sought medical advice which revealed no medical issues.
David then turned to exercise and weight loss, but his man boobs remained, and the pain persisted. By researching online, David suspected that he had gynecomastia. He found a gynecomastia surgeon who confirmed his suspicion. With the support of his wife, surgery was scheduled. David was thrilled after recovery from his surgery, his chest pain was gone, and he now had a masculine chest. He stated that after 20 years he feels like “a real man.” He now encourages other men to seek gynecomastia surgery and not wait 20 years like he did.
Gynecomastia.org is Worldwide
Dr. Miguel Delgado, M.D. recommends to his male breast reduction patients to view the website gynecomastia.org. Gynecomastia.org is the web’s best resource for information on gynecomastia. The site offers forums for men to share stories and ask questions of fellow forum members, and of member board certified plastic surgeons who specialize in gynecomastia.
Many countries are represented in the forums such as; Canada, the U.K., Asia, Australia, South America, the Middle East, and many more. Gynecomastia.org assists men in finding support and surgeons in their area.
Are you ready to have a normal male chest? Call Dr. Delgado today, (415) 898-4161 for a gynecomastia consultation.