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Category: Gynecomastia consultation

Gynecomastia Surgery, Where Will Your Incisions Be?

Gynecomastia surgery in San Francisco

                                    Before and After Gynecomastia Surgery

Deciding to have male breast reduction surgery is only the first step in achieving a nice contoured chest. Picking just any surgeon who states that they do gynecomastia surgery might be a big mistake. Selecting a board certified plastic surgeon can also be a mistake.

A Gynecomastia Specialist is a Must!

Choosing a board certified plastic surgeon is essential, but you must go further and determine if the surgeon specializes in man boobs. Ask how many male breast reduction surgeries are done each year and view many before and after pictures.

Ask the surgeon if you have breast tissue and fat. This can be determined by a physical exam. If you only have fat, it will feel soft, but if there is breast tissue present, it will feel firm. The majority of men have “true” gynecomastia which is a combination of fat and breast gland.

True Gynecomastia Requires Excision

If you have “true” gynecomastia, ask the surgeon during your consultation, if you will be having liposuction and surgical excision of the breast tissue. If surgical incision is going to be done, ask where the incisions will be. You want to hear that the tiny incisions for the liposuction cannula will be high up in the armpit so that when it heals, it will be undetectable. You also want to hear that the incisions for the surgical removal of the breast tissue will be around the bottom half of the areola. The incision around the areola once healed will be barely visible.

Extreme Gynecomastia, 2 Stage Surgery

There are exceptions to this, and that would be for the man that has extreme gynecomastia and may need his surgery done in two stages. However, with proper planning, the second stage incisions are to be done around the areola, but fully around the areola, removing a donut shape of excess skin, and then closed with purse string sutures. Note at two weeks post op the patient below, when fully healed the incisions will be barely detectable.

gynecomastia first stage

    Extreme Gynecomastia

Gynecomastia, First Stage After 6 months

Six Months After First Stage

gynecomastia two weeks after second stage

Two weeks after second stage

If you have “true” gynecomastia and the surgeon tells you that the fat and breast tissue can be removed by liposuction alone, this should be a red flag for you. Dr. Miguel Delgado, M.D.’s gynecomastia practice is at 40% for revision surgery. Most of the revision cases are to correct surgery where only liposuction was done. If the male breast is only fat, it is referred to as “pseudo-gynecomastia” and liposuction alone is a successful procedure.

Horizontal Mastectomy Incision

Some surgeons use a horizontal mastectomy incision for male breast reduction. Dr. Delgado finds this unacceptable, he feels the resulting scars are as bad as the condition that is being corrected.

After gynecomastia surgery

Horizontal Mastectomy Incision

Having decided to proceed with surgery, do your homework and ask lots of questions of your surgeon. Get more than one opinion if you have any doubts. Revision surgery is expensive and should be unnecessary.

Call Now!

For a consultation with Dr. Delgado, call (415) 898-4161.

 

The Birds and the Bees and Gynecomastia, Talk to Your Sons!

gynecomastia surgery in San Francisco

                                     Before and After Gynecomastia Surgery

Answering Your Children’s Questions

Talking about the “birds and the bees” with children is something that makes many parents uncomfortable. Parents need to decide how they will answer children’s questions. There are many self-help books and programs to help guide parents through tough questions. Children need to be prepared for changes as they go through puberty.

Wise parents will start early in discussions about puberty with their children. Using a matter of fact tone with age-appropriate information, is better than letting them hear stories from other kids, television, or other inappropriate sources. 

Adolescent Gynecomastia is Normal

As boys approach puberty, they may be excited to note that their voice is getting deeper and maybe getting new hair where hair didn’t grow before. They may be happy to see facial hair and can start shaving like Dad. However, there are more changes, up to 70% of boys may begin to develop breasts as they go through puberty, a condition known as gynecomastia.

Adolescent gynecomastia is a normal result of hormonal changes. Left untreated it will usually resolve itself within a few months up to 2 years. If boys aren’t aware that this is a normal phenomenon they may be terrified to see breasts appear on their chests. Most feel great shame and embarrassment and will try to hide their chest. They may be teased mercilessly from classmates, causing withdrawal from social activities. Usually, boys are too embarrassed to talk to their parents. Parents may be totally unaware that their son is suffering. Unfortunately, many parents are not familiar with gynecomastia.

Prepare Your Sons!

Today with the advent of the internet, information is readily available, and hopefully, the mystery of gynecomastia is a thing of the past. Parents need to prepare their sons of the possibility they may temporarily develop breasts before it happens.

If your son is having a hard time coping, it would be wise to seek a consultation with a board certified plastic surgeon that specializes in gynecomastia. Dr. Miguel Delgado, M.D. advises parents that in some cases male breast reduction surgery is available for young men, especially when it is affecting them psychologically.

Call Today!

If you have a son who is struggling with male breasts, call now (415) 898-4161 for an appointment with Dr. Delgado and learn what options are available.

Gynecomastia May Indicate a Serious Health Condition

Before and After gynecomastia surgery in San Francisco

                                           Before and After Gynecomastia Surgery

For the majority of men with gynecomastia, having male breasts are mostly a benign condition and pose no health concerns. But, the psychological impact can be devastating and impact self-esteem.

Gynecomastia and Health Concerns

However, some serious health conditions may cause gynecomastia; men with moobs should seek medical evaluation.

Some of the serious conditions known to cause gynecomastia are:

• Liver disease

The liver has many functions including clearing excess hormones from the body. If there is liver damage and estrogen is not metabolized correctly, it can lead to the development of breasts in men.

• Kidney Disease

Hormonal imbalance can occur with impaired renal function. With decreased testosterone and an increase of estrogen, man boobs may result. A kidney transplant can reverse the problem, but some drugs used after a kidney transplant may cause men to have breast development.

• Malnutrition

Prolonged starvation can cause temporary moobs. When malnourished men have lower testosterone, some systems increase function before others when a man returns to a normal diet. This phenomenon was noted when World War II prisoners of war came home.

• Male Hypogonadism:

When the testicles don’t produce enough testosterone the ratio to estrogen will be skewed with the probable result of man boobs. This could be a problem with the testes, the pituitary gland, or the hypothalamus.

• Human Chorionic Gonadotropin (hCG)

If a man has gastric carcinoma, large cell carcinoma, or renal cell carcinoma, his hCG levels won’t be normal, and moobs may form.

• Increase of Cortisol Levels:

Your adrenal glands make a steroid hormone called cortisol. Cortisol helps the body respond to stress, fight infections, and regulate blood sugar. Men experiencing a lot of mental stress may have excess cortisol in the body. Men with increased cortisol and estrogen, along with low testosterone will very likely have the development of male breasts.

Dr. Miguel Delgado, M.D. states there are more conditions can lead to the development of man boobs. As mentioned before, gynecomastia is mostly a benign condition but it can be an indication of other health issues and should be evaluated.

Don’t Wait, Call Now!

For any gynecomastia concerns, please contact Dr. Delgado at (415) 898-4161

 

Estrogen is in Your Food!

Estrogen in Food Causes Moobs

                                         Before and After Male Breast Reduction Surgery

Men’s body naturally produces estrogen, the “female hormone,” but in a much smaller amount than for women. When estrogen and testosterone are perfectly balanced, the body works as it should. However, Dr. Miguel Delgado, M.D. warns that several factors can unbalance the ratio of hormones that will lead to unwanted side effects such as infertility, erectile dysfunction, and gynecomastia.

Change Your Eating Habits

It is possible for men to lower their estrogen levels by changing their eating habits. If caught early, by avoiding some foods that are high in estrogen, they may be able to reverse some feminine characteristics they may develop before they become permanent.

Estrogen Rich Foods to Avoid

Soy – known as phytoestrogens (plant produced estrogen). This includes soy milk, protein drinks, protein powder, and in thousands of packaged foods. Read the labels! Most grocery store foods that contain soy are genetically modified (GMO). More than 90% of soy grown in the United States is (GMO). However, the traditional crop grown in Japan is not GMO. Miso, natto, and tempeh are fermented soy products and are the safe for consumption.
Sugar and Carbohydrates – Both are highly processed, and in addition to the adverse health effects, they cause the body to produce more estrogen.
Conventional Meat and Dairy – Milk may contain up to 20 medications and growth hormones. Growth hormones are given to cows so that they will produce more milk and grow faster. Look for milk that is organic or labeled “bGH-free.”

Beware of BPA!

When cleaning up your diet, you should also be aware of Bisphenol A (BPA). BPA has been around since the 1960’s and is an industrial chemical often used in the production of plastic water bottles and food containers. BPA mimics the hormone estrogen. Research has shown BPA can leach into beverages or food and cause health issues. Avoid water bottles that have been exposed to heat and foods that are microwaved in plastic containers.

Detox Your Body

You can start to detox your body by avoiding the listed foods and products and add cruciferous vegetables like cauliflower, broccoli, cabbage, Brussel sprouts, kale, etc. You can also increase your probiotic and prebiotic consumption through supplements or fermented foods like sauerkraut, kombucha, and kimchi.

Call Now!

If your breasts are starting to feel tender or painful do not wait, call (415) 898-4161 for an appointment with Dr. Miguel Delgado, M.D.

Moob Surgery and Reasonable Expectations

unilateral moob in San Francisco

22 year old male presents for unilateral right gynecomastia. Hormone testing proved normal. He had gland excision on the right with liposuction. He is seen here 4 weeks post op.

 

No one has a perfect body, most men carry some extra weight, some are barrel-chested, or some may have a somewhat concave chest. Like women, a lot of men may have one breast larger than the other. It is unknown why some people have more of a propensity to form scar tissue than others. All of these factors can contribute to moob surgery results.

Moob Surgery Complications are Rare

Complications are infrequent, but when they do occur they usually are minor, and most can be treated as an office procedure. However, all surgeries come with some risk such as:

• Bleeding (hematoma)
• Blood clots
• Infection
• Adverse reaction to anesthesia

Specifically for gynecomastia, there can be pigment changes, some asymmetry of the breasts or nipples, loss of sensation or numbness in the nipples which is possible to last up until a year, rarely is it permanent.

Under or Over Resection

Men who are seeking gynecomastia revision surgery usually have not had enough tissue and/or fat removed; this is referred to as “under resection.” Under resection is a common outcome when the surgeon only uses liposuction for moob reduction. Another complication is “over resection” where too much fat and tissue has been removed, also known as a “crater deformity.”

In some instances, men complain that a few weeks after surgery they have “puffy nipples” for most, this is due to the development of scar tissue which generally takes a few weeks to develop. Many times the scar tissue can be resolved with steroid injections done in the office.

Common Conditions After Moob Surgery

Dr. Miguel Delgado, M.D. states that after the trauma of surgery, moob patients will find that there will be swelling, and bruising, but when, where, and how much can’t be determined. Additionally, scar tissue will form, but again how much can’t be predicted.

After obsessing about their man boobs for a long time, some men will be looking for perfection. Plastic surgery is not a perfect art; however, significant improvement can be expected.

Find an Experienced Moob Surgeon

In the hands of an experienced board certified plastic surgeon that specializes in gynecomastia, many steps can be taken to assure a great outcome. A general surgeon and even some board certified plastic surgeons do not have the skills that a gynecomastia specialist has for a very complex surgery.

It is the expert gynecomastia surgeon who understands possible complications and how to treat them.  This is the surgeon who does 100’s of male breast reductions surgeries a year, not just a few. View many before and after pictures and select a surgeon with impressive results.

Call Now!

Dr. Delgado has 100’s of before and after pictures available for viewing, call today (415) 898-4161 for a consultation.

 

Gynecomastia Do’s and Don’ts

Gynecomastia before and after in San Francisco

                                                 Before and After Gynecomastia Surgery

Gynecomastia or male breasts can be an extremely humiliating condition for men. Many men will go to great lengths to be rid of their man boobs.

• Over the Counter Products

We have yet to hear of any product that you can buy that will reduce men’s boobs. The most advertised come in pill form and the only thing that gets reduced will be your wallet. Check the forums on gynecomastia.org and read many comments by men who have tried them.

• Diet and Exercise

Diet and exercise are always recommended but not as a way to reduce male breasts. Unless you have pseudo-gynecomastia (breasts caused by fat only)diet and exercise will not reduce breast tissue. Fat may be reduced but the remaining breast tissue will look even more prominent.

• Taking Hormones

Hormone imbalance is the major cause of breast growth for men. Some men believe if they increase their testosterone level it will reduce their man boobs. This is a big misconception; it can actually increase breast growth as the additional testosterone may get converted into estrogen. Messing with your hormone levels is very risky.

• Compression Vests and Layering of Shirts

For some men they will try to hide their chest by wearing several layers of shirts or wear a compression vest. This may work for some, but the bulkiness will be quite uncomfortable after a time and too hot in the warmer seasons.

• Gaining Weight

In an effort to hide man boobs, some have tried to gain weight with the idea that the breasts won’t be as obvious. This is not a good idea, as the breasts which contain fat cells, will grow bigger as well.

  • Recommendation

What is recommended is for you to consult with a gynecomastia specialist. Most people today know that they should consult with board certified doctors, but in the case of man boobs, you need to go a step further. In addition to being board certified, you want a surgeon who specializes in gynecomastia and has done hundreds of cases, not just a few a year. Dr. Miguel Delgado, M.D. warns that male breast reduction surgery can be very complex and in the wrong hands you may end up not only dissatisfied but in need of revision surgery. It is best to get it right the first time! When in consultation or even before making an appointment, ask how many cases the doctor does on average each year. View before and after pictures of patients so you can see what type of results you can expect.

Call Today!

For any gynecomastia concerns you may have, call now (415) 898-4161 for an appointment with Dr. Delgado who has specialized in male breast reduction since 1988.

Massage After Gynecomastia Surgery

Massage for Gynecomastia patients in San Francisco

Scarring can be very unpredictable, and no two patients will heal the same. As the body recovers after gynecomastia surgery, there will be scar tissue forming both internally and externally. Sometimes the scar tissue may feel lumpy, and some men are fearful their man boobs are returning. This scar tissue is not breast tissue and will not affect the overall appearance.

Scar Tissue After Gynecomastia Surgery

Scar tissue will not disappear if it is massaged, but there are benefits to be gained, Dr. Miguel Delgado, M.D.  has his patients start a gentle massage after about 3 weeks as long as it is not painful. To start massaging before then may cause unwanted swelling.

 

The Benefits of Massage

The skin may feel hypersensitive as healing takes place and sensation starts to return. Massage may reduce the sensitivity. In addition, massaging can help the body get rid of pockets of fluid and reduce swelling. Massage may help internal scarring to be looser and more flexible. Massaging external scars with a lubricant may prevent scars from cracking and drying out.

How to Massage

If you are instructed to start massaging, the way to do it is; raise one arm over your head, take the three middle fingers of the opposite hand and gently use a circular motion on areas that feel firm. Gradually increase the intensity, but not to the point that it hurts. Massage for about 5 minutes on each side two times a day.

Options for Scar Revision

It isn’t possible to avoid scar formation after surgical procedures. However, there are treatment options available to reduce scar tissue such as; steroid injections, or even a minor scar revision surgery.

Do not attempt massaging your chest unless directed by your surgeon.

Call Now!

For additional information for any gynecomastia concerns, call today (415) 898-4161 for an appointment with Dr. Miguel Delgado, M.D.

 

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 for Out of Town Patients

In general, patients choose their cosmetic plastic surgeon close to home for convenience and for easier follow-up care. For the most part, there are excellent board certified plastic surgeons in all parts of the United States. However, there is an exception to this, for some specialties such as gynecomastia, finding an expert may involve travel.

Gynecomastia Specialist for Surgery

Many surgeons will perform male breast reduction, but if they are less experienced, the results may lead to necessary revision surgery. It is better to get it right the first time; it will be less expensive, time-consuming, and better results.

It is essential for men to do their homework in researching the surgeon of their choice. Be sure to review many before and after pictures, read reviews, and make sure the surgeon is board certified in plastic surgery. Go on two or three or more consultations until you feel comfortable with the surgeon and the staff.

Gynecomastia, before and after

                                                       Before and After Gynecomastia Surgery

Surgical Excision and Liposuction Needed

Gynecomastia.org is a wonderful informational website dedicated to men searching for answers to many questions they may have about their male breasts. There are gynecomastia specialists on the forums along with the members who will answer questions and share stories. Be sure you understand that “true gynecomastia” involves both surgical excision and liposuction to get the best results. Do not opt for liposuction alone unless what you have is “pseudogynecomastia.” Pseudogynecomastia means only fat is causing your male breasts.

Dr. Miguel Delgado, M.D. states that over 40% of his practice is gynecomastia revision surgery where other surgeons did not remove enough tissue, or they removed too much. Don’t let this happen to you!

Men Travel From Afar to See Dr. Delgado

Dr. Delgado’s reputation as a gynecomastia specialist is nationwide and beyond. Men travel from all over the United States and other countries to be treated by him. Dr. Delgado appreciates that men are willing to travel far distances to see him, so he has implemented many protocols to assist his out of town patients.

Dr. Delgado offers a complimentary consultation either by Skype, or phone, after a patient sends pictures. After the consultation, the patient will be provided with a detailed quote. If the patient decides to come to Novato for surgery, a surgery date will be set, and a comprehensive booklet will be sent giving the patient pre and post-operative instructions.

Special Rates for Out of Towners

                                                                                                                                                                     Novato Oaks Inn                                                                                                                                                                                                                                                                                                                   The patient needs to arrive a couple of days before surgery for a pre-operative visit.  Dr. Delgado has arranged a special rate for out of town patients at the Novato Oaks Inn, be sure to mention his name when making reservations. The hotel is nearby and offers a free shuttle to the office.

Patients need to plan on staying a week after surgery for their follow up care, including drain and suture removal. Once home, Dr. Delgado will keep in touch by phone or Skype to follow your recovery.

Make an Appointment Today!

Contact us now to get your free virtual consultation with Dr. Delgado. For your complimentary consultation, email the following information to us at info@dr-delgado.com:

  • Your name
  • Age, weight, height
  • Upload pictures of your chest, front and profile
  • Your phone number and when we can contact you

 

Scar Tissue After Gynecomastia Surgery

Scar tissue After Gynecomastia surgery in San Francisco

Before and After Gynecomastia Surgery

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.

Call Now!

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.

 

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