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Category: Gynecomastia revision

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.

 

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 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.

 

Gynecomastia Surgery and the “Light Pull-Through Procedure”

light pull-through surgery in San Francisco

This 29 year old man suffered from adolescent gynecomastia. He had glandular excision and liposuction of the chest.

For the majority of men with gynecomastia, the most effective treatment is surgical excision of the glandular tissue along with liposuction for fat removal and sculpting.  A small percentage of men have “pseudo-gynecomastia.” Pseudo-gynecomastia means their breasts are caused by fat and no breast tissue. In this case, liposuction alone may give them the desired results.

“Light Pull-Through” How it is Done

 

light pull-through procedure in San Francisco

There is another gynecomastia surgery known as the “Light Pull-Through Procedure.” This is an excellent choice for men with mild to moderate gynecomastia and good skin elasticity. Only a small

incision is made at the lower edge of the areola, about 3 to 5 mm. Through this incision, a cannula is inserted, and fat is removed by liposuction. Then, a special instrument similar to a “pickle fork” is used to free up glandular tissue by cutting connecting fibers. Next, the breast tissue is gently pulled through the incision, and the small amount of remaining tissue is blended with special scissors. In some cases, drains may be placed for 24 to 48 hours.

Fast Recovery

Candidates for this procedure will have less surgery time, and recovery is faster. Scarring is minimal and will fade to almost invisible.

Some patients who come to Dr. Miguel Delgado, M.D. for gynecomastia revision surgery had only liposuction to remove their male breasts. These men are unhappy with their results because the breast tissue was left behind giving them unsatisfactory results. Unfortunately, they may have been a candidate for the “Light Pull-Through Procedure” but now due to the scar tissue that naturally forms after liposuction; their revision surgery has become more complex.

Patient Selection is Critical

Patient selection for this procedure is critical. Schedule a consultation with Dr. Delgado now (415) 898-4161 to find out what gynecomastia procedure would give you the best results.

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 free 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.

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