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Category: Gynecomastia revision

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.

 

Avoiding Loose Skin After Gynecomastia Surgery

The Doctor's Show

“The Doctors” TV show recently aired an episode featuring a gynecomastia patient who had a BodyTite treatment for male breast reduction. BodyTite is a duel treatment combining liposuction with radio frequency energy that melts fat and tightens skin at the same time.

Intense Marketing for Liposuction

There are many different types of liposuction such as; tumescent, ultrasound, and laser assisted, and each one has multiple catchy names. There has been intensive marketing with inflated claims that make for a lot of confusion for potential patients trying to figure out what treatment would be best for them.

Dr. Miguel Delgado, M.D. has stated that over 40% of his gynecomastia practice is revision surgery for men that have had their original surgery done by another surgeon. Many of these surgeons used liposuction alone and did not surgically remove the breast tissue. Breast tissue is too dense to be removed by liposuction effectively, no matter what is claimed.

The Gold Standard for Gynecomastia Surgery

Liposuction with surgical excision remains the gold standard. For “true” gynecomastia there are no shortcuts. However, patients who have “pseudogynecomastia” which is male breasts caused by fat alone, liposuction can be a good treatment.

Dr. Delgado uses a different technique for skin tightening that gives better results than radio frequency devices. In order to contract the skin, he applies controlled heat directly to the underlying skin (subcutaneous tissue) to avoid surgical excision of loose skin.

Choose Your Surgeon Wisely!

Who does the liposuction is more important than what it is called. Regardless of the type of liposuction used, for “true gynecomastia” surgical excision of dense breast tissue is necessary.

Call today (415) 898-4161 for an appointment with Dr. Delgado who is Board Certified in Plastic Surgery and has specialized in gynecomastia since 1989.

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.

Gynecomastia Revision is Needed Should I go to the Same Surgeon?

Miguel Delgado, M.D.

Miguel Delgado, M.D.
Gynecomastia Specialist
★★★★★ Ratings: 4.74 -118 Reviews

 

 

 

 

 

 

 

 

 

 

 

Change Surgeons?

This is a good question and needs thoughtful consideration. The answer should depend on what type of revision is needed and why. Highly trained Board Certified Plastic Surgeons that specialize in gynecomastia surgery will explain risks and complications, prior to surgery.

There are Risks

All surgeries come with some risks; the main ones are, infection, bleeding, blood clots, and adverse events related to anesthesia. Although rare, patients need to be aware of the possibility. Additionally and specifically to gynecomastia surgery would be where the original surgeon tried to correct gynecomastia by liposuction alone, without removing breast tissue by surgical excision. Almost all gynecomastia cases need both liposuction and surgical excision; the only exception would be for men that have pseudo-gynecomastia (only fat, and no breast tissue). The second main reason for revision would be; under or over resection of the breast tissue. This would require re-excision for under resection or fat injections or fat flaps for over resection. How complications are managed has a direct relationship to the outcome.

Crater Deformity

Over Resection Causing Crater Deformity

Post Surgery for Crater Deformity

Post Surgery for Crater Deformity

Miguel Delgado, M.D. Gynecomastia Specialist

Miguel Delgado, M.D. has years of experience with revision gynecomastia surgeries, in fact up to 40% of his gynecomastia practice is revision surgeries that come to him from other practices.

If what is needed is a minor adjustment after the initial surgery, such as minimal skin tightening, this should not be considered unusual. If men are not prepared for the possibility of a secondary surgery, it can be very disconcerting, and may cause them to question the capabilities of their surgeon.

Second Opinions Advised

The first step is to have a frank discussion with your surgeon. If you do not feel convinced that your surgeon can correct the issue; it might be of value to get one or two second opinions. Corrective surgery can be very challenging and requires the skill of a gynecomastia specialist. Revision surgery is not as straight forward as the initial surgery, as now the surgeon must deal with scar tissue that has formed from the first surgery and possible loss of some elasticity of the skin.

Contact us!

If you are in need of gynecomastia revision surgery, email (info@dr-delgado.com) or phone (415 898-4161) to meet with Miguel Delgado, M.D. to learn what options are available to you.

The Gynecomastia Consultation, What to Expect

Miguel A. Delgado, Jr., M.D. - Gynecomastia Specialist

Miguel A. Delgado, Jr., M.D.
Gynecomastia Specialist

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.

Gynecomastia Surgery Redo Now at 40%

 

pics Male patient before and after Gynecomastia Surgery

This 49-year-old man had gynecomastia surgery twice with other physicians. He sought my help wanting to undergo a third procedure as he was still unhappy with his result. He underwent glandular excision and suction-assisted lipectomy of the chest.

San Francisco, California-On August 17, 2010, I published a blog “Liposuction for Gynecomastia”. At that time,  I stated the percentage of redo surgeries that were originally done by other surgeons was at 25% to 30%.

Today, the percentage of redo male breast reduction surgeries in my practice has increased to 40%! This is due to the same reason as before. There are many surgeons that believe the desired results of a well sculpted male chest can be attained by liposuction alone. When liposuction alone is used, breast tissue remains and it can actually look more prominent than before the fat was removed.

True gynecomastia is a combination of fat and breast tissue. The fat can be removed very well by liposuction; however, the breast tissue is too dense to come through the cannula. Breast tissue needs to be removed by excision, and it needs to be done by a gynecomastia specialist who has the expertise to give a masculine contour to the chest.

If the breast tissue is removed too aggressively, the result can be a crater deformity, another cause for redo. This is an extremely frustrating situation for the man who has finally had surgery to correct his moobs. The good news is that almost all of these cases can be corrected, but just emphasizes the fact that men need to do their homework in picking a Board Certified Plastic Surgeon for gynecomastia reduction surgery. Ask a lot of questions, request to see before and after pictures, ask how many male breast reduction surgeries are performed each year, you want to be sure to pick a gynecomastia specialist so that a gynecomastia redo surgery will not be necessary. A good source for Board Certified Plastic Surgeons is www.gynecomastia.org.

 

Crater Deformity - image

Crater Deformity

 

After Surgery for Crater Deformity Correction - pic

After Surgery for Crater Deformity Correction

Will Liposuction Get Rid of Moobs?

 Liposuction and Gynecomastia Treatment

Before and After Liposuction and Gynecomastia Treatment

Before and After Gynecomastia Surgery

This question is asked frequently by San Francisco Bay Area men, and the answer is; rarely will liposuction alone get rid of man boobs. True gynecomastia is a combination of fat and breast tissue. Liposuction will only effectively remove fat. Breast tissue is too dense to go through a cannula.

Liposuction Treats pseudogynecomastia

There are many surgeons who attempt to remove moobs by liposuction alone, they leave behind the breast tissue which now without the surrounding fat may be even more apparent.   I would say that 35% to 40% of my male breast reduction cases are “redo” surgeries where the original surgeon used liposuction alone. This presents a more difficult “redo” surgery because now there is scar tissue making dissection more difficult and the skin may have lost much of its elasticity. This is especially frustrating for the patient who will have to go through another surgery involving more expense and recovery time and maybe not the result that could have been obtained if breast tissue had been excised in the original surgery.   There are instances when liposuction is a great tool, but mostly it should be used for touch up procedures, to extract and/or inject fat. In the rare case where the male breast is caused by fat alone, liposuction may be very effective. This is not considered “true gynecomastia” however; it is referred to as “pseudo-gynecomastia”.  In many cases, pseudo-gynecomastia can be reversed with weight loss if the skin has not been overly stretched.   In order to avoid needing a “redo” surgery, be sure to find a Board Certified Plastic Surgeon that specializes in gynecomastia surgery. Look at the surgeons before and after photos, and ask questions as to the method of surgery to be used.

Liposuction assist in gynecomastia surgery.

 

What You Need to Know Before Gynecomastia Surgery

 

Miguel A. Delgado, Jr., M.D.

Male breast reduction surgery is now the 4th most popular cosmetic surgical procedure for men according to the American Society of Plastic Surgeons. The percentage of cases has been increasing each year as more men become aware that surgery is an option to get rid of their man boobs.

Once the decision is made to pursue surgery, the gynecomastia patient needs to find a cosmetic plastic surgeon that is Board Certified in Plastic Surgery. Look for one that specializes in gynecomastia surgery. The surgeon should be able to present you with many before and after pictures of their patients. Ask how the procedure will be done. Most gynecomastia procedures need to have liposuction and excision of breast tissue in order to get the best result. In some cases liposuction alone can give a good result, but this is for the patient who has what is known as “pseudo-gynecomastia” which means the gynecomastia is caused by fat alone. I would say at least 30% of my gynecomastia surgery cases are “redo” cases where liposuction alone was done leaving behind breast tissue.  Having to redo the surgery is much more difficult for now there is scar tissue to deal with and the skin may have lost some of its elasticity.

Lastly in looking for a surgeon  in San Jose or any San Francisco Bay Area, ask where the procedure will be performed, check to see  if the facility is accredited and if the anesthesiologist is Board Certified.

What Happens if I am not Happy With my Gynecomastia Surgery Result?

Marin Cosmetic Surgery Center Staff - photo

Marin Cosmetic Surgery Center Staff

Dr. Delgado realizes that, for some San Francisco Bay Area men, it is hard to make the decision to go forward with male breast reduction surgery, some worry about what happens if they are not satisfied with the result.

Dr. Delgado’s main goal is patient satisfaction. At the time of the initial consultation he is very attentive to the patient’s concerns, he wants to be sure he understands what the patient’s goals are. He then describes to the patient what the surgery entails; stating that no surgery is perfect but tremendous improvement can be expected.

If a  revision is needed within the first year for the gynecomastia breast, there is no charge if it can be done as an office procedure. If it needs to be done at Marin Cosmetic Surgery Center, there is still no professional fee by Dr. Delgado, but there may be fees for anesthesia and the operating room.

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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