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.
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.
Before and After Gynecomastia Surgery for a Body Builder
Steroids and Body Builder in 6 Part Video
Dr. Miguel Delgado, M.D. presents a 6 part video where he performs a double incision mastectomy with a free nipple graft. Dave, a body builder, has severe gynecomastia due to his steroid use. This procedure can also be used for a man who has had massive weight loss, or someone with severe gynecomastia with excessive skin.
The video series will take you through the pre-operative visit, live surgery, to post-op visits.
Dave’s Steroid Use and His Story
In Dave’s story, he tells us he had been on steroids a long time before he had any development of male breasts. He did not notice any changes in his breasts until he stopped the steroids. He tells Dr. Delgado that he did not take any anti-estrogen as he was unaware of steroid side effects.
After he weaned himself off steroids and losing some weight, he became aware of his breast development. He was hoping that if he lost weight his male breasts would also reduce but found that was not the case, he learned that only the fat around the breast tissue would increase or decrease but not the breast tissue. The breast tissue is permanent, and surgery is the only way to get rid of it.
Dave tells Dr. Delgado how he lost his confidence as a professional athlete and trainer, once he developed breasts. He comes to Dr. Delgado for help so he can regain his confidence and be able to wear tight fitting shirts again.
Dr. Delgado explains that with surgery not all of the breast tissue is removed in order to have an aesthetically sculpted chest. Dr. Delgado warns Dave that if he should continue with steroids, it is possible that he could have a recurrence of breast tissue although not to the extent he now has. Dave states that he wishes to continue in moderation with steroids because as a man in his 50’s it is difficult to maintain his muscles in the way he wants. Dr. Delgado tells him that some men can take steroids with no adverse effects while others can take small amounts and develop breasts.
Exciting Results After 5 Months!
In the last video, you will see Dave at 5 months post-op with an excellent result. He is extremely happy and has had no recurrence of breast development. View all videos below.
If you have male breasts due to taking steroids or even unknown causes, call Dr. Delgado (415) 898-4161 today for a consultation.
This man has suffered from adolescent gynecomastia. He underwent glandular excision and liposuction of the chest, total fat extraction of 500cc from the right side and 450cc from the left. Total glandular tissue removed was 17 grams from the right side and 14 grams from the left.
Considerations For Surgery
The best time to have male breast reduction surgery is when you have decided to do it! However, if you are flexible, there are some things to consider when scheduling your surgery.
After surgery, you will be wearing a compression vest for the first 6 weeks of your recovery. In the winter time, the compression vest will keep you warmer as you will be wearing warmer, heavier clothing that will hide the vest.
Hiding Male Breasts
Wearing baggy clothing is how many men hide their male breasts, and after surgery, to conceal their compression vest. The compression vest isn’t as difficult to hide, as Dr. Miguel Delgado, M.D. has designed his own compression garments that are more comfortable and functional than other vests. However, for the first 2 or 3 days you will have drains in place, and even with the convenient pockets in the Delgado vest for the drains, it is a little bulky and easier to hide under a heavy shirt.
Enjoy Your Summer
Summertime is when men want to spend more time outdoors wearing tank tops, T-shirts, and even going shirtless. Having surgery in the winter time will allow your recovery to take place before the summer months. Dr. Delgado recommends that you still use sunblock on your scars for a good 6 months and even up to a year. As long as the scars are still pink, you need protection with sunscreen of at least 30 SPF, to avoid hyperpigmentation (scars turning permanently dark). Regular shirts and T-shirts do not protect scars from the sun’s rays, use a good sunscreen.
After gynecomastia surgery, you will need to take a break from your exercise program for 4 to 6 weeks. If jogging, bike riding, or other outdoor activities are your exercise choice, missing a few weeks in winter may be preferable than the pleasant days of summer.
If you have been thinking about gynecomastia surgery, now is the time to schedule a free consultation with Dr. Miguel Delgado at (415) 898-4161.
You may know some of the common causes of gynecomastia such as; puberty, steroids, medications, and aging. However, there are some lesser known ones that you should be aware of.
Men have more androgen hormones and women more estrogen, but when the ratio gets out of balance for men, the result could be man boobs.
The following are some more obscure reasons that men may develop male breasts, but Dr. Miguel Delgado, M.D. wants to remind men that sometimes the source of gynecomastia remains unknown.
• Deprivation Diets
If you should go on a strict diet that deprives your body of needed nutrients, testosterone levels will fall, but not estrogen levels. Men may not grow breasts while on a deprivation diet, but they may find when they return to a normal diet, they may develop breasts. The term for this is “re-feeding gynecomastia.” This phenomenon was first noted when prisoners of war returned to the U.S. after World War II. When the soldiers returned to a normal diet, they developed breasts.
• Weight Gain
The ratio of muscle to fat gets thrown off when one gains excessive weight. As the proportion of breast tissue to fat rises, the body will produce more estrogen, the female hormone, and not as much androgen. When this occurs, breasts may develop.
• Alcohol and Beer
Consuming alcohol and beer will put on pounds and if in excess could lead to cirrhosis of the liver. It is hard for the body to rid itself of estrogen and phytoestrogen which are present in hops that are in beer and other plants in hard liquor. The liver metabolizes hormones, and if the liver is somewhat compromised, it may convert androgen into estrogen leading to female type breasts.
• Cigarette Smoking
It is known that cancer produces hormones for its own growth which results in imbalances and can then grow breasts on men. Various types of cancer may cause gynecomastia such as testicular cancer and lung cancer. More reasons to try to quit smoking for good!
• Rifle Shooting
This may be the most surprising reason for the growth of male breast tissue. It was discovered that 70% or more German military men who perform precision drills, develop gynecomastia. It is unknown what causes a rise in estrogen from a rifle backfire!
When consulting with Dr. Delgado for gynecomastia, be sure to inform him of all meds, your family history, and lifestyle, to help him determine the possible cause for your male breasts.
If you have been researching gynecomastia, you probably have heard of numerous things that can trigger gynecomastia, such as; puberty, steroids, illegal substances, obesity, aging, alcohol, hormonal imbalances, medications, etc.
There is one gynecomastia cause that you might not have heard about, and that is Tribulus Terrestris which is an herb used as a nutritional supplement that enhances testosterone production. In addition, the herb is touted to increase sexual function, improve muscle recovery, and exercise performance.
Increased Estrogen Equals Man Boobs
However, with all these great benefits there is a downside to this herb, and that is it may cause gynecomastia. Tests have shown the herb increases testosterone levels producing a hormonal imbalance. As a consequence, the body will produce more estrogen resulting in man boobs.
There are many other herbs that have been associated with gynecomastia, some of them are; tea tree oil, lavender oil, grape seed, dong quai, saw palmetto, ginseng, to name a few.
Some Foods are Estrogenic
Furthermore, there are foods that are considered to be estrogenic, such as; soy products, legumes, chickpeas, and cowpeas, and some red meats that come from animals raised on synthetic hormones. Consuming too many foods that are laden with estrogenic substances can affect the balance of hormones resulting in breast growth.
Before and After Gynecomastia Surgery
Trying to self-diagnose what may be responsible your female type breasts is nearly impossible. Dr. Miguel Delgado, M.D. advises men to seek the advice of a Board Certified Plastic Surgeon who specializes in gynecomastia. Be sure to inform the surgeon of all supplements, herbs, medications, diet, lifestyle, and family history to help find the source of your gynecomastia.
Some Gynecomastia Causes are Unknown
Finally, it is possible that the origin of your man boobs may never be discovered, it remains unknown for many men. However, gynecomastia is not a life-threatening condition although for many it causes severe embarrassment. Whatever the source, surgery is the only proven treatment for permanent removal of male breasts.
You no longer have to feel ashamed of your male breasts, call today (415) 898-4161 for a consultation with Dr. Delgado who has been performing male breast reduction surgery since 1988 and is an expert in his field.
To schedule a free consultation with Dr. Delgado in San Francisco, California or Novato in Marin County call 415-898-4161. You may also send us a e-mail at info@DR-Delgado.com or fill out our quick contact form. Send photos of your chest for a virtual consultation TODAY. We have a complimentary travel package for out of town patients that include travel to and from the airport, four nights stay at the Novato Oaks Inn and travel from the hotel to the office.
Please feel free to fill out the form below for a price quote or to contact us with any questions or comments you may have.
Dr. Delgado has offices in Marin and San Francisco for your convenience
450 Sutter Street Suite 2433 San Francisco, California 94108 (415) 989-2221