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Category: Gynecomastia consultation

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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Does Weed Cause Gynecomastia?

Weed After gynecomastia surgery

Gynecomastia sufferers ask   Dr. Miguel Delgado, M.D.  “will smoking marijuana cause gynecomastia?” Another popular question is, “If after male breast reduction surgery if I smoke cannabis, will my man boobs come back?”

Do Doobies Make Boobies?

There are many different causes of male breast enlargement. A primary cause is puberty, when a young man goes through hormonal changes; also obesity, steroid use, and aging are known causes. Each patient is unique and what may trigger breast growth in one man might not for another.

There is not any conclusive evidence that marijuana contributes to gynecomastia, but there are many patients and physicians that believe it is so.

Medical Daily quotes Marijuana.com saying “Doobies Make Boobies,” but not for women. Animal studies show exposure to delta-9-tetrahydrocannabinol known as THC (the active ingredient in weed) decreases testosterone levels, however, human studies remain inconclusive. There are many conflicting reports that lead to a lot of confusion.

Gynecomastia Surgery Increases 5%

The Mayo Clinic lists marijuana along with amphetamines, alcohol, heroin, and methadone as potential causes of male breasts. Additionally, on the list of causes, there are herbal products and many medications.

Robert Murphy, Jr., president of the American Society of Plastic Surgeons, believes there is a correlation with the 5% increase in gynecomastia cases last year and the acceptance and easier access to marijuana in the United States.

With the link between gynecomastia and cannabis highly probable, you must ask yourself if after having male breast reduction surgery “is the high worth it?”

Call for a Consultation Today!

Call Dr. Delgado (415) 898-4161 now if you are having any concerns about your male breasts.

Gynecomastia Surgery After Weight Loss

 

After significant weight loss, gynecomastia sufferers have an additional issue to deal with. Besides reducing male breasts, there is now redundant, tissue, fat, and skin requiring more contouring and skilled techniques.

2 Stage Gynecomastia Surgery

Some men are candidates for the 2 stage procedure. The first stage removes breast tissue and fat under the skin. The second stage is a minor procedure that can be done in the office under local anesthesia. Excess skin is removed around the areola in a doughnut shape and is closed with a purse-string type sutures.

Before and After Stage One Gynecomastia Surgery

Before and After Stage One Gynecomastia Surgery

 

He is seen two weeks after Stage Two Surgery

Massive Weight Loss and Gynecomastia

For men who have had massive weight loss, most will likely not get desired results with the more traditional procedure of removal of fat and tissue with a hidden incision around the areola. Instead, for the more severe cases, the patient may need an incision going around the areola and a vertical incision to the breast crease creating an anchor reduction.

The anchor incision, also known as an inverted T, will leave visible scars. Most patients understand the trade-off and are accepting of the procedure in order to obtain the best breast shape.Male chest After weight Loss

Male Chest After Weight Loss 

After gynecomastia surgery

After Gynecomastia Surgery

 

Many patients find their incisions heal nicely and are comfortable with their results. For others, it is possible they may develop keloid scars which are raised and can be quite noticeable.

Scar Care After Gynecomastia Surgery

Today there are several different treatments available to help with scar management. The experienced board certified gynecomastia specialist will use deep suturing techniques to reduce tension on the skin that helps avoid keloids. Once the incision has healed silicone sheeting is applied, it will help keep the skin hydrated, which helps in scar control.

Additional preventive measures include; steroid injections, scar massage, and laser treatment such as the Palomar Laser. As a last option, scar revision may be done, but that will involve another incision.

Call Today!

Gynecomastia patients are encouraged to call Dr. Miguel Delgado at (415) 898-4161 for a consultation.

Scar Solutions After Gynecomastia Surgery

 

A disappointing result after gynecomastia or male breast reduction surgery is the possible scarring that forms around the areola when the incisions heal. Men faced with unsightly scars feel they have traded one problem for another.

Too Much Collagen Forms Scars

It is not known why some people are more susceptible for scar formation than others. Scars are a natural result of the body healing itself when there has been trauma to the skin. During the healing process, the body produces collagen fibers that will end up having a different texture than the surrounding skin. Sometimes the body will over produce collagen, creating a buildup of tissue, resulting in a firm raised scar known as keloid or hypertrophic scars.

Before and After Scar Treatment

Before and After Scar Treatment

In most cases, it is not medically necessary to remove these benign scars. However, if they are noticeable, they may cause a lot of discomfort to the gynecomastia patient who wants to be able to go shirtless after surgery.

Options for Scar Removal

There are several options available for scar removal including; surgical excision, steroid injections and laser treatment, such as the non-invasive Palomar Icon Fractional Laser.

Having your initial gynecomastia surgery performed by a Board Certified Plastic Surgeon who specializes in gynecomastia, is your best bet for avoiding noticeable scars. Patient participation in preventing unsightly scars is crucial. Be sure to follow your surgeon’s post-operative instructions that should include; avoiding direct sunlight for 6 months to a year. Sunlight is known for contributing to hypertrophic scars. Using silicon sheeting once the incisions have healed have proved to be very beneficial in scar prevention.

Gynecomastia Surgery in San Francisco

Before and After Gynecomastia Surgery

If you are struggling with unsightly scars after gynecomastia surgery, schedule a consultation today (415) 898-4161 with Dr. Miguel Delgado, M.D. to find what options are available to you for removal.

Puffy Nipples After Gynecomastia Surgery!

Puffy Nipples in San Francisco

Puffy Nipples                                    After Corrective Surgery

 

Many men complain about puffy nipples after healing from gynecomastia surgery. Liposuction is great for fat removal but will not remove the gland effectively.

Gynecomastia Revision Surgery

Dr. Miguel Delgado, M.D.’s gynecomastia practice consists of about 40% revision cases after surgery performed by another surgeon. Removing the correct amount of tissue and fat from the male breast takes the expertise of a board certified plastic surgeon that specializes in gynecomastia. Many surgeons are very conservative in their removal of tissue to avoid creating a crater deformity. However, when too much gland is left behind, it will push the areola out causing “puffy nipples.”

Crater Deformity in San Francisco

Crater Deformity

After Corrective Surgery

1 Month After Corrective Surgery

 

Gynecomastia patients that have had male breast reduction surgery and end up with puffy nipples are understandably discouraged because their only recourse is a secondary surgery to remove additional breast gland. This revision surgery is a little more complicated due to scar tissue that has formed from the initial surgery.

Choose Your Surgeon Carefully

It is important to choose your surgeon carefully. First, make sure that he or she is board certified in plastic surgery. Secondly, make sure your surgeon has extensive experience with gynecomastia surgery, taking the right amount of fat and tissue is critical to get the precise sculpting for the chest. If too much is removed a crater deformity will be the result, if not enough gland is removed, you will end up with puffy nipples. In both cases additional surgery will be required for correction, it is much better to get it right the first time.

Help is on the Way!

Call now (415) 898-4161 for a consultation with Dr. Delgado if you are suffering from male breasts or are in need of gynecomastia revision.

Preparing for Gynecomastia Surgery

The educational organization, “The American Society for Aesthetic Plastic Surgery,” (ASAPS), is a society made up of board certified plastic surgeons. The society’s purpose is to sponsorscientific meetings presenting the latest developments in cosmetic plastic surgery.

Smart Beauty Guide for gynecomastia

“The Smart Beauty Guide” was created by ASAPS to educate patients and assist in their making of informed choices when it comes to cosmetic surgery. The guide has a section for gynecomastia surgery with pertinent information on all aspects of the surgery. In preparing for gynecomastia surgery, the guide recommends the following:

  • Sun tanning can increase scarring and should be avoided at least two weeks prior surgery.
  • Cigarettes and all nicotine products must be stopped for a minimum of 4 weeks before surgery, nicotine is known to interfere with healing.
  • All supplements and medications that thin the blood must be discontinued at least two weeks before surgery.
  • Staying hydrated before and after surgery promotes healing.
  • If you have any illness or infection before surgery, inform your surgeon.
  • Lab tests need to be done promptly.
  • If your work is labor intensive be sure to allow plenty of time off work for gynecomastia recovery.
  • You will need a responsible adult to take you home after surgery and accompany you for the first 24 hours.
  • Have books, movies, and a laptop available to keep you occupied while recovering.
  • Get all prescriptions filled in advance.

Dr. Delgado’s Gynecomastia Booklet

As a patient of Dr. Miguel Delgado, M.D. you will receive a 40 page preoperative booklet with detailed instructions for before and after male breast reduction surgery. Included in the booklet is an extensive list of all medications and supplements that need to be avoided.

Schedule a Gynecomastia Consultation

Being well prepared before surgery leads to a stress-free recovery. Call today (415) 898-4161 to schedule a gynecomastia consultation with Dr. Delgado.

 

Gynecomastia Consultation Questions

Gynecomastia questions

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!

before and after photo - banner

 

__ Contact Us For a Consultation

To schedule a consultation with Dr. Delgado in San Francisco, California or Novato in Marin County call 415-830-8883. 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 complimentary 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.

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