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Category: Forms of Gynecomastia

Gynecomastia Surgery, Is it Necessary?

Gynecomastia Specialist, Miguel Delgado, M.D.

                                          Before and After Gynecomastia Surgery

Gynecomastia is noncancerous enlarged breast tissue in men. Male breasts can develop when there is a hormonal imbalance of estrogen to testosterone. 65%  of men or more will develop breasts at some point in their life; it is often seen in newborn male babies, as boys go through puberty, and in the aging male. In most cases, the male chest will return to normal on its own within a few weeks to a few months.

Gynecomastia From Mild to Severe

There are 4 grades of gynecomastia, from mild to severe. After puberty, if the male breast has not returned to normal after 2 years, then surgery will be the only permanent solution.

Some men are comfortable with their breasts and do not feel the need to hide them. They are able to have a normal life without their breasts causing them any embarrassment. They enjoy the beach and pool parties or any situation where they remove their shirt. For these men, they do not need to consider surgery as the breast tissue is benign.

Male Breast Cancer is Rare

Gynecomastia has been known to be caused by certain medications used in the treatment for such conditions as; ulcers, prostate cancer, and heart conditions. However, even though gynecomastia is fairly common, male breast cancer is rare. There are only about 2,000 men a year diagnosed with breast cancer, and of that number about 400 die of the disease. Men with gynecomastia are slightly more at risk for breast cancer due to the elevations of estrogen. Additionally, men are more at risk for breast cancer if it is in their family history, Jewish ancestry, or some genetic disorders.

Dr. Miguel Delgado, M.D. states that even though the incidence of cancer is very low, men should get regular checkups, do self-breast exams, and always be on alert for any lumps, unusual swelling, or pain and see their doctor promptly.

Schedule a consultation now with Dr. Delgado (415) 898-4161 for any gynecomastia concerns.

Gynecomastia Surgery, Sometimes a Two-Stage Procedure

 

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.

Stage One

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.

gynecomastia first stage

Extreme Gynecomastia

For more severe cases such as the one pictured here, a secondary procedure is scheduled after four to six months after the first stage.

Stage Two

Gynecomastia, First Stage After 6 months

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

gynecomastia two weeks after second stage

Two weeks after second stage

Call now (415) 898-4161 for a gynecomastia consultation with Dr. Delgado.

Will Liposuction Alone Remove “Man Boobs?”

Liposuction and Gland excision Surgery in San Francisco

                                                      Before and After Gynecomastia Surgery

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.

Asymmetry and the Gynecomastia Patient

Gynecomastia is caused when excess estrogen gets stored in the male body which then leads to breast development.

Male Breasts May be Asymmetric

Usually, when a man develops gynecomastia, the breasts are relatively equal in shape and size. However, it is not uncommon for one breast to develop and be larger than the other. In rare cases, it is possible for only one breast to develop. Asymmetry causes men to feel even more self-conscious than men with enlargement on both sides.

asymmetry gynecomastia in San Francisco

This 43 year old man had liposuction in 1992 for his gynecomastia with another surgeon but was not satisfied with the results. Dr. Delgado performed revision surgery, consisting of suction-assisted lipectomy and glandular excision of the chest. Total fat extraction was 350cc from the right side and 375cc from the left to correct his asymmetry.

Some asymmetry is normal, but when it becomes very noticeable, it can be the cause of much embarrassment and shame.

Asymmetry is Corrected by Surgery

The only way to correct asymmetry is by surgery with a gynecomastia specialist. The surgery entails liposuction, surgical excision of the breast tissue with the goal of a masculine contoured chest.

Sometimes asymmetry can occur during male breast reduction surgery by unseen complications or lack of skill by the surgeon. A secondary surgery will be necessary for correction, be sure to choose your surgeon carefully! The patient will need to wait about 6 months before revision surgery can take place.

Dr. Delgado’s Revision Surgery on the Rise

Dr. Miguel Delgado, M.D. states that about 40% of his gynecomastia practice is made up of revision surgery where patients had their surgery done elsewhere. Most revision cases are correction of too much tissue removed (crater deformity) or not enough tissue removed, along with asymmetry.

Call Today!

If you have had unsatisfactory gynecomastia surgery or hope to avoid revision surgery, call now (415) 898-4161 for an appointment with Dr. Delgado who has been performing male breast reduction surgery since 1988.

Gynecomastia Article by Dr. Miguel Delgado Reaches Near and Far

 

Gynecomastia is Worldwide

Gynecomastia is a common condition that affects a large percentage of men worldwide. India, in particular, has shown great interest in gynecomastia and it is reflected in the many inquiries from Indian men on such websites as Gynecomastia.org.

Dr. Delgado Explains the Struggle With Moobs

The Deccan Chronicle is the largest circulated English newspaper in South India. Recently the Deccan Chronicle picked up a story that was published in Daily Mail Online on: “My Struggle With Moobs’: Inside the Booming Industry of ‘Man Boob’ Reconstruction Surgery.

The interview with Daily Mail Online gives a comprehensive outline on causes and solutions as presented by San Francisco Board Certified Plastic Surgeon, Dr. Miguel Delgado, M.D. a specialist in gynecomastia.

Steroids and Puberty Set the Stage

Man Boobs or gynecomastia is the development of female type breasts on a man. The major cause is in young men as they go through puberty, however, for the majority, it will resolve on its own. The second major cause is bodybuilders or athletes who use steroids. Once the breast tissue starts to grow the only solution will be surgery.

Dr. Delgado explains the simpler cases and also the more extreme cases that may need to be done in stages. This is not a “one size fits all” type surgery, but it is very individual with precise planning for each case. The patient below is an example of extreme gynecomastia.

 

gynecomastia first stage

Preoperative, patient with severe gynecomastia

First Stage After 6 months

6 months after first stage; gland excision, liposuction, superior crescent lift, and external lift sutures.

 

 

 

gynecomastia third stage

2 weeks after second stage; peri-areolar lift with donut shape skin excision

Call Today!

Whether you live near or far, call (415) 898-4161 for an in-person consultation, or if you are out of town or out of the country you may Skype, email or have a phone consultation with Dr. Delgado.

 

 

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The Different Grades of Gynecomastia

Half of all men or more will have to deal with gynecomastia or male breast enlargement at some point in their life. One of the major causes of breast enlargement is for young men as they go through puberty. Fortunately for most, their breasts will return to normal within a couple of months to a couple of years. For others, surgery may be the only solution.

Adolescent gynecomastia in San Francisco

This 21-year-old young man suffers from adolescent gynecomastia. He underwent glandular excision and suction-assisted lipectomy. His goal was to “reduce my puffy nipples.”

The Severity of Gynecomastia Varies

Gynecomastia comes in several degrees of severity. According to the American Society of Plastic Surgeons (ASPS), there are four grades to help with identification.

• Grade I: severity mild, localized tissue felt just below the areola
• Grade II: severity mild to high, breast enlargement exceeds the boundaries of the areola without excess skin
• Grade III: severity high and visible, exceeding the boundaries of the areola with excess skin
• Grade IV: severity high and visibly feminine with excess skin

Gynecomastia affects each patient differently. In addition to various sizes and severity, the shape of the breasts may differ, and in some cases may be of conical shape. For some men, each breast may develop differently. A male breast reduction specialist is able to make the breasts of equal size.

“Risperdal” Causes Gynecomastia

The term gynecomastia became more well-known after the lawsuit against Johnson and Johnson for their drug “Risperdal.” Risperdal is prescribed for the treatment of bipolar disorders and autism in children. Risperdal was discovered to cause gynecomastia as a side effect for some young boys. The class action suit was widely televised by attorneys seeking to represent victims. Johnson and Johnson settled the suit with one of the highest payouts in history.

Gynecomastia Causes Emotional Problems

Gynecomastia is not physically dangerous; however, it can be the cause of low self-esteem and other emotional problems. Finding a gynecomastia specialist can be a challenge, do your homework, make sure your surgeon is board certified in plastic surgery, and view many before and after pictures, and read online reviews.

With the different grades of gynecomastia, men need to realize the surgery is not one size fits all. Each case is individual and the approach for surgery must be customized. The cost for surgery will vary depending on the complexity of the case.

Contact a Gynecomastia Specialist!

If you are in the Bay Area, call Dr. Miguel Delgado, M.D. at (415) 898-4161  for any gynecomastia issues. Dr. Delgado has been treating men with male breasts since 1989; his reputation has grown nationwide and worldwide. Many men travel from all parts of the United States and around the world to see Dr. Delgado, see the generous travel package offered to his patients.

Can Breasts Grow Back After Gynecomastia Surgery?

Before and After gynecomastia surgery in San Francisco

                                        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:

• Obesity
• Imbalance of testosterone and estrogen levels
• Decrease in testosterone production, common in older men
• Some medications
• Marijuana and other recreational drugs
• Psychological stress

Idiopathic Gynecomastia

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.

Call Now!

If male breasts are disrupting your life, call  Dr. Delgado (415) 898-4161 today for a consultation.

Allure Magazine Features Breast Reduction for Men

 Allure Magazine

Allure, the popular magazine that touts itself as the beauty authority, offers beauty tips and features articles on fashion, beauty products, and news in cosmetic plastic surgery.

A recent article published in Allure addresses why more men are getting male breast reductions than ever before. As reported in our previous blog, the article starts out quoting statistics by the American Society of Plastic Surgeons on breast reduction surgery showing that men for the first time accounted for 40% of the total.

Stigma for Men Removed

Allure points out how social media and reality shows have helped lift the stigma of men having cosmetic surgery. While women have breast reduction surgery to alleviate back, neck, and shoulder pain, men are more likely to seek surgical correction due to the embarrassment of their female type breasts.

Gynecomastia comes in varying degrees of severity. For mild cases, men who work out want a more toned look with their pec muscles more apparent. Gynecomastia surgery can help achieve their goal by removing and sculpting the layer of fatty tissue sitting on top of the muscle. For moderate to severe breast development, men seek gynecomastia surgery so that they can feel more comfortable when they go shirtless.

Quick Recovery

Allure points out that men today are more likely to pursue male breast reduction surgery because not a lot of time off work is necessary. Recovery is relatively quick and their shirts hide their post-operative garments.

Get Help Today!

Miguel Delgado, M.D. encourages men suffering from gynecomastia to call (415) 898-4161 or email [email protected] today for a consultation.

Gynecomastia Discussed on the Nip/Tuck Talk Show

 

Nip/Tuck Interviews Miguel Delgado, M.D.

No More Man Boobs!

Michele Garber interviewed Miguel Delgado, M.D. for almost an hour on her Nip/Tuck Talk show. The discussion addresses the frustrating and humiliating condition known as gynecomastia. Ms. Garber’s in-depth interview covers causes and surgical options for men of all ages.

What You Need to Know About Gynecomastia

1. What is the best age for surgery?
2. Can enlarged male breasts come back?
3. Are there non-surgical options?
4. What are the risks of steroid use?
5. When will liposuction alone not work?
6. When is it recommended to see an endocrinologist?

California Board Certified Gynecomastia Specialist Explains

“Many young men may find that their male boobs are still present well after puberty,” states Miguel Delgado, M.D. However, the younger males have the best gynecomastia surgical outcome due to the good elasticity of their skin. Many men find they develop breasts as they age or gain weight. Dr. Delgado warns of the risks caused by different types of drugs and steroids.

To hear answers to these topics and many others, you can listen to the interview in its entirety here: http://niptucktalk.com/podcast/category/treatments-for-gynecomastia.

A Gynecomastia Consultation May Change Your Life

Miguel Delgado, M.D. emphasizes that each male breast reduction patient is unique; the solution is not “one size fits all.” Call (415) 898-4161 or email [email protected] today for a personal consultation with gynecomastia specialist Miguel Delgado, M.D.

Common and Rare Causes of Gynecomastia

Common Causes Cured by Gynecomastia Surgery

Before and After Gynecomastia Surgery

 

 

 

Physiologic Gynecomastia

Gynecomastia is the proliferation of benign glandular breast tissue in men. Gynecomastia can be physiologic (normal body function), such as in newborns, adolescent young men and older men after the age 50. Gynecomastia can also be non-physiologic occurring at any age.

For physiologic gynecomastia, newborn babies may show breast development due to the conversion of androgenic hormones to estrogenic hormones by the placenta. However, for babies the breast usually returns to normal within a few weeks. For adolescent boys going through puberty, many will develop puffy nipples and/or fullness of their breast as they go through normal changes in hormone levels. However, for most young boys their gynecomastia breast will return to normal within a few weeks to a maximum of a couple of years. Male breast development is common in the aging man as testosterone levels begin to drop. Many older men choose to have male breast reduction surgery later in life.

Common Causes

Other more common causes for gynecomastia are medications, anabolic steroids, chemotherapy, dialysis, alcohol and marijuana abuse.

Uncommon Causes

Men need to be aware of uncommon causes that can attribute to the gynecomastia breast such as Graves’ disease and Klinefelter’s syndrome. Breast cancer in men is rare, accounting for only 1% of all breast cancers, however for men with Klinefelter’s syndrome, the incidence of breast cancer is 50 times higher.

For men who are malnourished, testosterone levels drop but estrogen continues to be produced causing an imbalance of hormones. Once normal nutrition takes place, male breasts may develop, this is called “re-feeding gynecomastia.” This phenomenon was noted when many malnourished prisoners of war were released after World War II. Within 1 to 2 years, the condition corrected itself.

Lavender and Tea Tree Oil

Another possible rare cause of gynecomastia in pre-pubertal boys could be the repeated use of lavender and/or tea tree oil as these

Can Lavender Oil Cause Gynecomastia

Lavender Oil

oils mimic the actions of estrogens and may inhibit the effects of androgens. National Institutes of Health (NIH) says more research needs to be done to support the link between these oils and gynecomastia.

It can be very challenging to determine the cause of gynecomastia. It is important for men with gynecomastia breasts to seek an evaluation from a Board Certified Plastic Surgeon that specializes in gynecomastia, who can determine if further evaluation from an endocrinologist may be recommended.

Get an Expert Opinion

Men with any gynecomastia concerns are encouraged to email or call (415) 898-4161 to set a consultation with Miguel Delgado, M.D., who has specialized in gynecomastia since 1989 and is considered an expert in the field.

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