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: 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.
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.