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Category: Gynecomastia scars

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, Sometimes a Two-Stage Procedure

 

For men with moderate to severe gynecomastia, a different approach for male breast reduction surgery is required. Older men who have lost elasticity of their skin or have had a massive weight loss of 100 to 200 pounds may have a tremendous amount of loose skin. Some surgeons will opt for a mastectomy type surgery where removal is done in one procedure. However, Dr. Miguel Delgado, M.D. tries to avoid this as he feels the resulting scar that goes across the chest is almost as disturbing as the large breasts

Gynecomastia Specialist, Dr. Miguel Delgado

A gynecomastia specialist, Dr. Delgado has been performing gynecomastia surgery since 1988. Dr. Delgado believes the way to get the best surgical result for a man with severe gynecomastia is to do male breast reduction surgery in two stages.

Stage One

The first stage is done with aggressive excision of the breast tissue along with liposuction. If the patient doesn’t have a lot of loose skin, a crescent lift may be done. A crescent lift is where a half donut shaped piece of skin is excised above the areola that reduces sagging and the lower fold. For some patients, the result is such that they may choose not to have a secondary procedure, but the scar will be  more visible at the top of the areola.

gynecomastia first stage

Extreme Gynecomastia

For more severe cases such as the one pictured here, a secondary procedure is scheduled after four to six months after the first stage.

Stage Two

Gynecomastia, First Stage After 6 months

Six Months After First Stage

The secondary procedure is the periareolar lift. The periareolar lift removes a donut of skin completely around the areola. After healing, the incision will blend into the areola extremely well.

Post Op at Two Weeks

gynecomastia two weeks after second stage

Two weeks after second stage

Call now (415) 898-4161 for a gynecomastia consultation with Dr. Delgado.

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.

 

Dr. Delgado Talks About Drains and Compression Vests

 

Dr. Delgado, a specialist in gynecomastia has been performing male breast reduction since 1989. Considered one of the top gynecomastia surgeons in all of the United States he has patients who travel from all parts of the United States and other countries to be treated by him.

Dr. Delgado is a Leader in Gynecomastia

Dr. Delgado provides the latest in technology and technique to his patients, many of which he designs himself. The result is a high satisfaction rate he receives from his patients. In the before and after pictures below is a delighted patient who wanted to share his own photos.

Dr. Delgado has a happy patient

In listening to his patients, Dr. Miguel Delgado,M.D. learned that the tiny scar left by the incision made for the drain was quite bothersome to many patients. Dr. Delgado explains in detail the need for drains; you can read more about that in the blog dated September 2017. Note in the after picture below where you can see the small scar right below the armpit.

Scar from drain before new technique

 

By moving the incision high up into the armpit, once it has healed patients have a hard time locating it!

Patient Comfort is Key

Another innovation by Dr. Delgado is the design of his unique compression vests. Previously commercial vests were bulky and did not have a provision for the awkward drain bulbs. Before, the bulbs were attached to the vest with a safety pin as shown in the picture.

Dr. Delgado vest

Dr. Delgado designed his vest with removable pockets that hold the bulbs. Once the drains were removed, the pockets came off making the vest less bulky. Also, the shoulder straps are adjustable allowing for more comfort. Then there is a second stage vest that is used when healing has progressed. The second vest is made of thinner material and has compression over the chest only. Lined with a soft T-shirt fabric, the vest is even more comfortable and undetectable under most shirts.

Call Today!

Are you ready to address your gynecomastia concerns? Call now(415) 898-4161 for an appointment with Dr. Delgado; you will be glad you did!

 

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.

The Best Time to Have Gynecomastia Surgery

 

 

Before and After gynecomastia surgery in San Francisco

This man has suffered from adolescent gynecomastia. He underwent glandular excision and liposuction of the chest, total fat extraction of 500cc from the right side and 450cc from the left. Total glandular tissue removed was 17 grams from the right side and 14 grams from the left.

Considerations For Surgery

The best time to have male breast reduction surgery is when you have decided to do it! However, if you are flexible, there are some things to consider when scheduling your surgery.

After surgery, you will be wearing a compression vest for the first 6 weeks of your recovery. In the winter time, the compression vest will keep you warmer as you will be wearing warmer, heavier clothing that will hide the vest.

Hiding Male Breasts

Wearing baggy clothing is how many men hide their male breasts, and after surgery, to conceal their compression vest. The compression vest isn’t as difficult to hide, as Dr. Miguel Delgado, M.D. has designed his own compression garments that are more comfortable and functional than other vests. However, for the first 2 or 3 days you will have drains in place, and even with the convenient pockets in the Delgado vest for the drains, it is a little bulky and easier to hide under a heavy shirt.

Enjoy Your Summer

Summertime is when men want to spend more time outdoors wearing tank tops, T-shirts, and even going shirtless. Having surgery in the winter time will allow your recovery to take place before the summer months. Dr. Delgado recommends that you still use sunblock on your scars for a good 6 months and even up to a year. As long as the scars are still pink, you need protection with sunscreen of at least 30 SPF, to avoid hyperpigmentation (scars turning permanently dark). Regular shirts and T-shirts do not protect scars from the sun’s rays, use a good sunscreen.

After gynecomastia surgery, you will need to take a break from your exercise program for 4 to 6 weeks. If jogging, bike riding, or other outdoor activities are your exercise choice, missing a few weeks in winter may be preferable than the pleasant days of summer.

Call Now!

If you have been thinking about gynecomastia surgery, now is the time to schedule a free consultation with Dr. Miguel Delgado at (415) 898-4161.

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 Surgery Recovery, What to Expect

Gynecomastia surgery in San Francisco

Be Patient, Swelling Takes Weeks to Resolve

Recovery from gynecomastia surgery, like most surgeries, will go through several stages. You will experience bruising and swelling. The bruising may be minimal, or for some, it can be quite extensive, healing can take 2 to 3 weeks.

Swelling is normal with most of it subsiding in a few weeks but may take several months for all of it to resolve. However, severe swelling can be the sign of something more serious such as a hematoma. A hematoma is bleeding under the skin. A very low percentage of Dr. Delgado’s patients experience this complication due to his advanced surgical techniques.

Drains and Sutures

Drains will be placed at the end of your surgical procedure to remove fluid that accumulates naturally. The drains will be removed at the first post-operative visit, usually within 2 to 3 days. Additionally, sutures are removed after 1 week.

After surgery, Dr. Delgado has his patients placed in a compression vest to be worn for 6 weeks and emphasizes there is to be no strenuous exertion or formal exercise for 4 to 6 weeks.

Protect Gynecomastia Scars From the Sun

Patients are warned to keep their chest out of the sun for several months. The sun can cause hyper-pigmentation on fresh scars turning them permanently dark. Once a scar is no longer pink sun exposure should be safe, but the use of sun block is recommended.

Gynecomastia patients may have a temporary decrease in the sensation of the nipple-areola complex, for most patients it is insignificant, but for some, it may take a year for full sensation to return. Massage is recommended to reduce hypersensitivity of the skin as sensation returns.

Blood Thinners Must be Avoided!

Dr. Miguel Delgado, M.D. warns patients to continue to avoid all blood thinners for at least 2 weeks after their surgery because it is possible to still have a bleeding issue. In addition, he advises his patients to follow a healthy diet for a faster recovery.

Schedule a gynecomastia consultation today (415) 898-4161 with Dr. Delgado to address any male breast issues you have.

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 free consultation today (415) 898-4161 with Dr. Miguel Delgado, M.D. to find what options are available to you for removal.

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