Miguel A. Delgado, Jr., M.D.
San Francisco, CA-Most patients are nervous when they have an appointment to see the doctor. This is especially true for patients seeking elective procedures as they have additional concerns about vanity and may feel guilty for indulging in something that is not necessary but will make them feel better about themselves.
It is the exceptional office that has a staff that understands the feelings of the new patient and has the ability to make them comfortable from the moment they arrive for their first consultation visit.
When arriving for a gynecomastia initial consultation, the patient will be escorted to an exam room and will be joined by Dr. Delgado. Dr. Delgado’s warm and friendly manner puts patients immediately at ease. Many patients have made the comment that they do not feel that Dr. Delgado talks down to them as many doctors are known to do, but more on an equal basis that builds trust and allows the patient to feel comfortable asking any questions that they may have.
To begin the consultation, Dr. Delgado has several questions he will ask. Usually he will want to know how long the patient has had male breasts, and when did they develop. He will want to know if there has been any noticeable change with weight gain or loss. Does he take his shirt off in public? Do other men in the family have gynecomastia? And what are his goals?
At this point, Dr. Delgado explains his surgical technique of excision combined with liposuction, pointing out that liposuction alone is only for the patient that has what is known as “pseudo-gynecomastia”, meaning fat alone is causing the male breasts. He points out that 40% of his gynecomastia cases are now revision surgeries, due to the original surgeon using liposuction alone and leaving breast tissue behind.
He goes into great detail to explain how the incisions are placed around the areola so that after healing they are almost invisible.
Drains are placed at the end of surgery Dr. Delgado explains, in order to remove fluid that normally collects when there is a “dead space” left after removal of fat and tissue. He shows how a compression vest will be worn to assist in the healing of the chest, and that he has them custom made to include pockets for the drains. Further, he says that the vest will be worn for 6 weeks and after that all normal activities including exercise can be resumed.
Now Dr. Delgado will do an exam of the patient’s chest and will be able to give a personalized evaluation of what he recommends. After the examination, the patient then will meet with Dr. Delgado in the office of the patient care coordinator. Dr. Delgado has several albums of before and after pictures of his male breast reduction patients that he presents. He will show where the incisions are and how they healed; he shows the small scar from the drain and how he now has it hidden in the armpit. These photographs will give the patient a good idea of Dr. Delgado’s work, and the results that can be anticipated.
Many patients choose to have additional surgery done at the same time to save money and recovery time. For patients that are interested, Dr. Delgado will show pictures of patients that have had a combination of surgeries. Popular add on surgery, for example, would be, liposuction of the love handles and/or abdomen, some may want facial surgery such as a rhinoplasty (nose job) or eyelid surgery or possibly a chin implant. Dr. Delgado will be happy to discuss additional surgery at the initial consultation if requested.
At the end of the consultation with Dr. Delgado, the patient then meets with the patient coordinator who will present the fees outlining gynecomastia costs and answer any additional questions the patient may have such as pre-operative and post-operative instructions, financing, and scheduling surgery. The patient is encouraged to call the office at any time with additional questions for the patient coordinator or Dr. Delgado.
In his quest to educate his patients and make them as comfortable as possible prior to the consultation, Dr. Delgado produced a 6 part video that is posted on his website and You Tube showing the whole process from the initial consultation to post-operative visits and the patients final impressions.