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. Gynecomastia Specialist
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 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.
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.
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.
For more severe cases such as the one pictured here, a secondary procedure is scheduled after four to six months after the first stage.
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
Two weeks after second stage
Call now (415) 898-4161 for a gynecomastia consultation with Dr. Delgado.
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.
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.
Castle Connolly Medical Ltd. Publishes a variety of books and guides to help consumers find the best in healthcare. This is invaluable information especially for people who are new to an area. The most popular book they put out is “America’s Top Doctors.” In addition to the books, Castle Connolly has a website directory.
Castle Connolly Selects Top Doctors
Thousands of American physicians are surveyed. The doctors are carefully reviewed by Castle Connolly research team. Some things the team considers are; education, residency, fellowships, board certifications, professional reputation, and much more. The selected doctors are considered the best in their specialty. Doctors cannot pay to be included in the directory, nor can they nominate themselves.
Castle Connolly Medical, Ltd. was launched in 1992 by two professional leaders in healthcare. John K. Castle was a member of the Board of New York Medical College for 22 years, and Chairman of the Board for 11 years. Dr. John Connolly was President of New York Medical College for over 10 years.
Media Recognizes “America’s Top Doctors”
Many major media outlets have recognized “America’s Top Doctors,” to name a few:
Good Morning America
Weekend Today in New York
Multiple newspapers include:
New York Times
Popular magazines include:
Town & Country
And many more
It is possible for physicians to be removed from the list. They may be removed if; they retire, are unavailable to patients, take a full-time administrative post, have any mal-practice or disciplinary issues, negative feedback from patients or physicians.
Finding Your Gynecomastia Specialist
For patients searching for a gynecomastia surgeon, “America’s Top Doctors” is a good start. In addition to confirming your surgeon is Board Certified in Plastic Surgery, be sure the surgeon is a gynecomastia specialist. Ask to view before and after pictures of the surgeon’s male breast reduction patients.
Before and After Gynecomastia Surgery
Dr. Miguel Delgado, M.D. has been performing gynecomastia surgery since 1989, and is considered one of the very top gynecomastia specialists in the United States and the world. Patients travel great distances to be treated by Dr. Delgado.
Dr. Delgado offers assistance to out of town patients to make their travels worry-free. He arranged a discount at a nearby hotel that includes free shuttle service to the office.
Make an Appointment Today!
Call now (415) 898-4161 to schedule a consultation with Dr. Delgado to discuss any gynecomastia concerns you may have.
This 29 year old man suffered from adolescent gynecomastia. He had glandular excision and liposuction of the chest.
For the majority of men with gynecomastia, the most effective treatment is surgical excision of the glandular tissue along with liposuction for fat removal and sculpting. A small percentage of men have “pseudo-gynecomastia.” Pseudo-gynecomastia means their breasts are caused by fat and no breast tissue. In this case, liposuction alone may give them the desired results.
“Light Pull-Through” How it is Done
There is another gynecomastia surgery known as the “Light Pull-Through Procedure.” This is an excellent choice for men with mild to moderate gynecomastia and good skin elasticity. Only a small
incision is made at the lower edge of the areola, about 3 to 5 mm. Through this incision, a cannula is inserted, and fat is removed by liposuction. Then, a special instrument similar to a “pickle fork” is used to free up glandular tissue by cutting connecting fibers. Next, the breast tissue is gently pulled through the incision, and the small amount of remaining tissue is blended with special scissors. In some cases, drains may be placed for 24 to 48 hours.
Candidates for this procedure will have less surgery time, and recovery is faster. Scarring is minimal and will fade to almost invisible.
Some patients who come to Dr. Miguel Delgado, M.D. for gynecomastia revision surgery had only liposuction to remove their male breasts. These men are unhappy with their results because the breast tissue was left behind giving them unsatisfactory results. Unfortunately, they may have been a candidate for the “Light Pull-Through Procedure” but now due to the scar tissue that naturally forms after liposuction; their revision surgery has become more complex.
Patient Selection is Critical
Patient selection for this procedure is critical. Schedule a consultation with Dr. Delgado now (415) 898-4161 to find out what gynecomastia procedure would give you the best results.
There are several different types of gynecomastia with varying degrees of severity. The amount of fat versus breast tissue varies greatly. Gynecomastia patients must be evaluated on an individual basis. Often the ratio of fat to breast tissue can’t be determined until surgery, and that will determine the surgical approach.
Liposuction Will Not Remove Breast Gland
Men with gynecomastia who research their options are lead to believe that liposuction alone may be their solution. Unfortunately, many plastic surgeons agree with this treatment. There are many different types of liposuction machines available today. Many surgeons claim they can remove fat and breast tissue with liposuction. However, no energy device can remove breast tissue that is found in almost 80% of gynecomastia patients. Breast tissue must be removed by surgical excision.
A small percentage of men have what is referred to as “pseudo-gynecomastia.” Pseudo-gynecomastia is where the male breast is almost all fat. For these men, liposuction is a great treatment. It is possible for these men to reduce their male breasts if they lose weight. If they are struggling with weight loss, liposuction or even CoolSculpting may be the answer. But men, who have breast tissue left behind after liposuction, will find they now have what is referred to as “puffy nipples.”
Liposuction May Leave Puffy Nipples
Puffy nipples are caused by breast tissue that remains behind the nipple. Without the fat as a buffer, the nipples protrude even more than before surgery. When researching gynecomastia surgery, check out unhappy patients who are seeking revision surgery on RealSelf.com and Gynecomastia.org.
Dr. Miguel Delgado, M.D. has been performing gynecomastia surgery for almost 30 years. He states that about 40% of his gynecomastia practice is revision surgeries, and most of them are for patients who had liposuction alone.
Make an Appointment Today!
Contact us now (415) 898-4161 for a consultation with Dr. Delgado for any male breast issues you may have.
Gynecomastia or male breasts cause a lot of embarrassment and humiliation for many men. Women have always had an easier time talking to each other about any health issues than men do. Through the ages, men have needed to present a strong, macho demeanor, but it is difficult if the man has female-type breasts. Many men try to hide their condition and then there are the brave ones that seek help and choose to have male breast reduction surgery.
Talk to Your Surgeon
Talking to a doctor about their gynecomastia is a big step. For men to get much-needed information starts them on their journey to be free of the shame that many of them have lived with for years.
Today with the vast amount of information that is presented online, men have discovered that they are not alone in their suffering and that there are solutions available.
#1 Website for Gynecomastia
In the privacy of their own home, men can sign on to the #1 online Community known as Gynecomastia.org. This site has an enormous amount of information on the website, but more importantly, there are forums where men can ask questions of each other and of gynecomastia specialists!
Gynecomastia.org has many categories such as; “Gynecomastia 101” which explains some of the known causes of gynecomastia, there is an “FAQ” section with answers to many questions and many more articles.
Wide Variety of Forums
The most popular section would be the “Forums.” All men are invited to participate in any of the forums which are quite varied. There are topics such as; • Surgery questions • Dealing with family members • Puffy nipples • Surgery success stories, to name just a few.
It is free to become a member, and as a member, you can post questions and share experiences. You may receive responses from other members or even from one of the member gynecomastia specialists’. There is also an international forum representing many countries such as; U.K., Canada, Asia, Europe, Australia, and more.
Gynecomastia Specialist are Members!
As mentioned there are gynecomastia specialists who are members of gynecomastia.org all of who are Board Certified Plastic Surgeons with a particular interest in gynecomastia. The surgeons are listed by state, and you can read their biography, philosophy and visit their website. This section is very valuable to men who are searching for a qualified Board Certified Plastic Surgeon in their area.
Many Before and After Pictures and Videos
Also, there is a vast amount of before and after pictures of many of the surgeon’s patients, along with educational videos. New blogs are frequently posted with updates on what is new with gynecomastia.
New gynecomastia patients who meet with Dr. Miguel Delgado, M.D. are advised to check out gynecomastia.org for support and educational purposes. Patients are always encouraged to contact Dr. Delgado if they have any questions or concerns. If you have wanted a gynecomastia consultation, call today for your personal meeting with Dr. Delgado. (415) 898-4161
26 year old male who presents with adolescent gynecomastia. He is 6 feet tall and weighs 245 pounds. He had 50 grams of breast tissue removed from his right chest and 77 grams from his left . He had 250 cc. of fat and aspirate removed from each side of his chest. His post op course was uncomplicated.
A seroma is a collection of clear serous fluid most often at a surgical site where tissue has been removed. This can be a complication after gynecomastia surgery. The swelling and fluid may not happen right away but can develop several weeks after surgery.
Seromas Lead to Serious Complications
Usually, a seroma will resolve in a few weeks, but the accumulation of fluid will cause the skin to sag and may cause discomfort. In some cases, a seroma can lead to serious complications, such as infection, and delayed wound healing. If an infection should occur, it may have developed into an abscess requiring medical treatment. The patient will be instructed to notify the surgeon of any noticeable swelling or abnormalities.
Small seromas may resolve on their own, but if left untreated they may calcify and form solid knots. Larger seromas may require needle aspiration or even drain replacement.
Methods of Prevention
Drainage is the most accepted method of prevention along with a compression garment. A compression vest will help the skin and tissue heal faster, reduce swelling and bruising and reduce the risk of developing a seroma.
A hematoma is different than a seroma in that a hematoma contains red blood cells, and an abscess is different as it contains puss from an infection.
Drains and Compression Vests
Some surgeons do not use drains, and some do not use compression vests after gynecomastia surgery. Dr. Miguel Delgado, M.D. not only advocates the use of drains, he also is a firm believer in compression vests. Dr. Delgado designed his own compression vests that he makes available to his patients. His custom-made vests have pockets for the drain bulbs to rest in, instead of being attached with safety pins. These custom-made vests additionally aid in binding the chest tissues together, decrease post-operative pain, and increase blood flow.
Dr. Delgado has over 25 years of gynecomastia surgery experience, and he states that his incidence of complications is very minimal. Call today (415) 898-4161 for a consultation for any gynecomastia issues you may have.