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Category: Gynecomastia consultation

Castle Connolly Selects Dr. Miguel Delgado Top Doctor Again!

Castle Connolly Top Doctors

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
  • 20/20
  • Morning News
  • Fox Cable
  • 48 Hours
  • Weekend Today in New York

Multiple newspapers include:

  • Chicago Tribune
  • Boston Herald
  • Daily News
  • New York Times

Popular magazines include:

  • Town & Country
  • Redbook
  • Fortune
  • Money
  • Atlanta Magazine
  • 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.

Castle Connolly Selects Gynecomastia Specialists

                                          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.


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.

Gynecomastia.org #1 Online Community

Gynecomastia surgery in San Francisco

                                                Before and After gynecomastia Surgery

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.

Call Now!

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



What Causes a Seroma and How to Avoid it

seroma and gynecomastia in San Francisco

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.


Are Your Supplements Causing Gynecomastia?

Gynecomastia and Herbs in San Francisco

Gynecomastia Triggers

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.

Gynecomastia surgery in San Francisco

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.

Call Now!!!

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.

Gynecomastia and Bad Posture



hunched shoulders before and after

Note the red line below the breasts in the before surgery picture which is caused by bad posture, is diminishing in the after picture.

Bad Posture Has Consequences

Almost all men with gynecomastia adjust their posture by slouching their shoulders and some even bend their spine to hide their pronounced breasts. Slouching and bending of the spine can have serious consequences, causing misalignment of the skeleton and muscles. Bad posture can lead to back and neck pain, arthritic joints, digestive problems and even breathing complications.

Men with bad posture make them look weak, unconfident, and insecure, affecting personal relationships, and may hamper job prospects. Over time the continuation of hunching over may shorten or lengthen bones and joints and may become permanent.

Cortisol, the “stress hormone”

In addition, bad posture may cause problems with ankles, knees, shoulders, and hips, which will lead to back pain and headaches. Eventually, there will be wear and tear of the joints and ligaments, cartilage, and lead to inflammation. If your body has chronic inflammation, it will produce more cortisol in response to the stress. The energy needed to produce more cortisol will reduce the production of testosterone.

Confidence Improves With Good Posture

When you stand straight, you feel confident, and when you feel confident, you stand straight. Similar to smiling leads to happiness and happiness leads to smiling.

Good posture allows the spine to withstand the pull of gravity and affects energy expenditure, hormone production and quality of life. Correcting posture can be difficult, but when a man has male breast reduction surgery, confidence grows, and he will want to stand tall and proud.

Gynecomastia is a Life-Changing Event

Dr. Miguel Delgado, M.D. wants his patients to know that having male breast reduction surgery can be a life-changing event, not only giving a man confidence and the freedom to bare his chest but to end physical and mental conditions that affect his quality of life.

If your male breasts have been a source of misery in your life, call now (415) 898-4161 for a consultation with Dr. Delgado and start your road to recovery!

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.

What to Expect After Gynecomastia Surgery

Gynecomastia surgery in San Francisco

Gynecomastia Surgery Results

Anticipating gynecomastia surgery may cause anxiety for many men. Not knowing what to surgery results to expect can cause further stress. The expert gynecomastia surgeon’s goal is to achieve a natural looking male chest with masculine contours. If the surgeon removes too much breast tissue, the result could be what is known as a “crater deformity,” and if not enough tissues is removed, more surgery may be needed. It is important to select an expert gynecomastia surgeon so you can get it right the first time!

Compression Vest and Drains

After surgery, you will be placed in a compression vest and have drains in place that remove excess fluid and keep swelling under control. The drains are generally removed within 2 to 3 days at the first post-operative visit. Sutures are taken out after 1 week. The vest is to be worn 24/7 for 5 or 6 weeks and only removed when showering. Showering is allowed a couple of days after the drains are removed, and the drain incisions have completely closed. When removing the vest, men need to realize that they are not seeing the final result. There will be swelling and bruising, and the incision at the bottom of the areola will be evident. However, bruising will completely subside in about a week to 10 days; swelling may last several weeks.

Incisions Well Hidden

As the incision around the areola heals, it will be almost undetectable due to the change of skin texture. The small incision from the drain at the side of the chest may leave a scar. Sensitive to men’s comments about this, Dr. Miguel Delgado, M.D. now places the drain incision high up in the armpit and toward the back, most men cannot find it after it heals.

It is not unusual for the swelling to take several weeks to completely resolve. Some swelling is normal as it increases blood supply to the injured area bringing nutrients that aid in healing. However, any unusual swelling needs to be monitored for a possible hematoma (abnormal bleeding outside blood vessels.)

Going Shirtless Becomes a Reality

As the swelling subsides, the final contour of the chest will become evident, and the ability to go shirtless will become a reality!

Unfortunately, for some men, once all the swelling has diminished they may have what is referred to as “puffy nipples.” The cause for puffy nipples is when the surgeon has not removed enough breast tissue that is behind the areola, and the tissue pushes the nipple outward. This condition can be fixed but requires additional surgery. Choose your surgeon carefully!

Call Today!

Gynecomastia patients are encouraged to call now (415) 898-4161 for a confidential consultation with Dr. Delgado.


Gynecomastia and the Link to Parabens


parabens and gynecomastia in San Francisco

Parabens have been used to prevent bacterial growth and as a preservative for many cosmetics and some foods since the 1950’s. They are cheap and stable and were believed to be safe until late in the 1990’s when it was discovered that there were some negative reactions.

Parabens Mimic Estrogen

Parabens have been deemed xenoestrogens, which mean they mimic estrogen. If parabens can be stored in the body, there is concern about the cumulative effect and possible health risks. However, to date, there is no scientific evidence to support any link with cancer. To identify parabens read all labels, note anything that ends in paraben, such as:

• Benzylparaben
• Methylparaben
• Butylparaben
• Propylparaben
• Ethylparaben

Before and After Gynecomastia in San Francisco
This is an 18-year-old man with significant gynecomastia who presents for gland excision and liposuction. His goal is to have a normal appearing chest. He underwent breast gland excision and liposuction. In addition, he had a superior incision for a crescent areola lift for superior advancement of the areola tissue.

Some men with high paraben concentrations may have lower muscle mass and more body fat and possibly have developed breasts. Japan has been doing research that showed there was damage to reproductive systems for some men and they had a lower sperm count along with lower levels of testosterone. Adding to these disturbing discoveries was the fact that damage was seen at doses lower than what is considered the acceptable daily intake.

Parabens in Food Banned in Europe

Europe outlawed the use of parabens in food in 2006, but in the United States, it is still used in many snack items. It is recommended that if you want to avoid them, read labels carefully and try to avoid processed foods and packaged pastries. Dr. Miguel Delgado, M.D. warns patients that what you put on your skin is as important as what you put in your mouth. Many products such as shampoos, lotions, deodorants, cosmetics, etc. have parabens in them.

Schedule an Appointment Today!

Men suffering from male breasts are invited to call now (415) 898-4161 for a consultation with gynecomastia expert, Dr. Delgado.


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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