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Category: Gynecomastia surgeon

What Causes a Seroma and How to Avoid it

seroma and gynecomastia in San Francisco

26 year old male who presents with adolescent gynecomastia. He is 6 feet tall and weighs 245 pounds. He had 50 grams of breast tissue removed from his right chest and 77 grams  from his left . He had 250 cc. of fat and aspirate removed from each side of his chest. His post op course was uncomplicated.

A seroma is a collection of clear serous fluid most often at a surgical site where tissue has been removed. This can be a complication after gynecomastia surgery. The swelling and fluid may not happen right away but can develop several weeks after surgery.

Seromas Lead to Serious Complications

Usually, a seroma will resolve in a few weeks, but the accumulation of fluid will cause the skin to sag and may cause discomfort. In some cases, a seroma can lead to serious complications, such as infection, and delayed wound healing. If an infection should occur, it may have developed into an abscess requiring medical treatment. The patient will be instructed to notify the surgeon of any noticeable swelling or abnormalities.

Small seromas may resolve on their own, but if left untreated they may calcify and form solid knots. Larger seromas may require needle aspiration or even drain replacement.

Methods of Prevention

Drainage is the most accepted method of prevention along with a compression garment. A compression vest will help the skin and tissue heal faster, reduce swelling and bruising and reduce the risk of developing a seroma.

A hematoma is different than a seroma in that a hematoma contains red blood cells, and an abscess is different as it contains puss from an infection.

Drains and Compression Vests

Some surgeons do not use drains, and some do not use compression vests after gynecomastia surgery. Dr. Miguel Delgado, M.D. not only advocates the use of drains, he also is a firm believer in compression vests. Dr. Delgado designed his own compression vests that he makes available to his patients. His custom-made vests have pockets for the drain bulbs to rest in, instead of being attached with safety pins. These custom-made vests additionally aid in binding the chest tissues together, decrease post-operative pain, and increase blood flow.

Dr. Delgado has over 25 years of gynecomastia surgery experience, and he states that his incidence of complications is very minimal. Call today (415) 898-4161 for a consultation for any gynecomastia issues you may have.

 

Are Your Supplements Causing Gynecomastia?

Gynecomastia and Herbs in San Francisco

Gynecomastia Triggers

If you have been researching gynecomastia, you probably have heard of numerous things that can trigger gynecomastia, such as; puberty, steroids, illegal substances, obesity, aging, alcohol, hormonal imbalances, medications, etc.

There is one gynecomastia cause that you might not have heard about, and that is Tribulus Terrestris which is an herb used as a nutritional supplement that enhances testosterone production. In addition, the herb is touted to increase sexual function, improve muscle recovery, and exercise performance.

Increased Estrogen Equals Man Boobs

However, with all these great benefits there is a downside to this herb, and that is it may cause gynecomastia. Tests have shown the herb increases testosterone levels producing a hormonal imbalance. As a consequence, the body will produce more estrogen resulting in man boobs.

There are many other herbs that have been associated with gynecomastia, some of them are; tea tree oil, lavender oil, grape seed, dong quai, saw palmetto, ginseng, to name a few.

Some Foods are Estrogenic

Furthermore, there are foods that are considered to be estrogenic, such as; soy products, legumes, chickpeas, and cowpeas, and some red meats that come from animals raised on synthetic hormones. Consuming too many foods that are laden with estrogenic substances can affect the balance of hormones resulting in breast growth.

Gynecomastia surgery in San Francisco

Before and After Gynecomastia Surgery

Trying to self-diagnose what may be responsible your female type breasts is nearly impossible. Dr. Miguel Delgado, M.D. advises men to seek the advice of a Board Certified Plastic Surgeon who specializes in gynecomastia. Be sure to inform the surgeon of all supplements, herbs, medications, diet, lifestyle, and family history to help find the source of your gynecomastia.

Some Gynecomastia Causes are Unknown

Finally, it is possible that the origin of your man boobs may never be discovered, it remains unknown for many men. However, gynecomastia is not a life-threatening condition although for many it causes severe embarrassment. Whatever the source, surgery is the only proven treatment for permanent removal of male breasts.

Call Now!!!

You no longer have to feel ashamed of your male breasts, call today (415) 898-4161 for a consultation with Dr. Delgado who has been performing male breast reduction surgery since 1988 and is an expert in his field.

Gynecomastia and Bad Posture

 

 

hunched shoulders before and after

Note the red line below the breasts in the before surgery picture which is caused by bad posture, is diminishing in the after picture.

Bad Posture Has Consequences

Almost all men with gynecomastia adjust their posture by slouching their shoulders and some even bend their spine to hide their pronounced breasts. Slouching and bending of the spine can have serious consequences, causing misalignment of the skeleton and muscles. Bad posture can lead to back and neck pain, arthritic joints, digestive problems and even breathing complications.

Men with bad posture make them look weak, unconfident, and insecure, affecting personal relationships, and may hamper job prospects. Over time the continuation of hunching over may shorten or lengthen bones and joints and may become permanent.

Cortisol, the “stress hormone”

In addition, bad posture may cause problems with ankles, knees, shoulders, and hips, which will lead to back pain and headaches. Eventually, there will be wear and tear of the joints and ligaments, cartilage, and lead to inflammation. If your body has chronic inflammation, it will produce more cortisol in response to the stress. The energy needed to produce more cortisol will reduce the production of testosterone.

Confidence Improves With Good Posture

When you stand straight, you feel confident, and when you feel confident, you stand straight. Similar to smiling leads to happiness and happiness leads to smiling.

Good posture allows the spine to withstand the pull of gravity and affects energy expenditure, hormone production and quality of life. Correcting posture can be difficult, but when a man has male breast reduction surgery, confidence grows, and he will want to stand tall and proud.

Gynecomastia is a Life-Changing Event

Dr. Miguel Delgado, M.D. wants his patients to know that having male breast reduction surgery can be a life-changing event, not only giving a man confidence and the freedom to bare his chest but to end physical and mental conditions that affect his quality of life.

If your male breasts have been a source of misery in your life, call now (415) 898-4161 for a consultation with Dr. Delgado and start your road to recovery!

Risperdal Lawsuits Increase in 2017

Risperdal lawsuits San Francisco

Risperdal is used to treat attention deficit disorder (ADD), bipolar disorder, and other mental issues. Dr. Miguel Delgado, M.D. states that studies have shown the drug can cause the development of female type breasts in men known as gynecomastia. Originally it was claimed that gynecomastia occurred in only 1 out of 1,000 patients. However, after being on the market for over 20 years, it is more than 20 times the original rate stated.

Risperdal Lawsuits Now Over 5,500!

In the first 3 months of 2017, more than 3,000 Risperdal lawsuits have been filed making the total now approximately 5,500. Last year one client was awarded $77 million, and there are several similar claims pending.

Johnson and Johnson canceled the tolling agreements on thousands of cases, which pauses the statute of limitations deadline, increasing the burden on the courts. Now there is no expiration date for filing a lawsuit; however, either side has the right to cancel the agreement.

So far 8 cases have gone to verdict in Philadelphia where the plaintiffs have won 4 and Johnson and Johnson have won 4. Appeals are still pending in Pennsylvania’s Superior Court.

TV Ads Attract New Claimants

You may have noticed millions of dollars are being spent on TV ads to attract new claimants for Risperdal litigation. In 2016 there were 3,800 TV ads that cost 2.6 million.

In 2016 74% of the plaintiffs did not live in Pennsylvania, which is not unusual for cases this size against pharmaceuticals companies. Now 36 states have filed lawsuits against Janssen, a subsidiary of Johnson and Johnson and the manufacturer of Risperdal, accusing them of hiding the dangerous side effects of the drug from health professionals and the public, and illegal marketing practices. Worldwide, Risperdal has profited over $30 billion.

Buyer Beware

Surprisingly, Risperdal is still prescribed by doctors and is not the subject of a recall.

If you have any questions or issues with female type breasts, contact Dr. Delgado now (415) 898-4161 for a personal consultation.

Gynecomastia and the Need for Drains

 Drain for gynecomastia in San Francisco

Some men have voiced concern about the use of drains after male breast reduction surgery. They are somewhat cumbersome, and a little uncomfortable when removed, but the advantages greatly out weight the disadvantages.

Drains May Prevent Infections

Drains collapse the “dead space” that is left after surgery. Without the drain, the space may collect fluid and can cause an infection or other complications. The type of drain used is called a Jackson Pratt which uses mild suction removing fluids through a clear plastic tube from the surgery site to a small bulb that is placed in a small pocket of the compression vest.

Periodically the bulb needs to be emptied and Dr. Miguel Delgado, M.D. wants the patient to keep a log of the amount of fluid removed and its color. This information is important for Dr. Delgado to monitor how the healing is progressing.

The most common drainage is serosanguinous, which is a thin watery substance usually pink to dark red from red blood cells. If the fluid is thick and the color is yellow, green, tan, or brown, it is referred to as purulent exudate and may be an indication of bacteria present in high levels or an infection.

Experience Proves the Advantage of Drains

Some surgeons use drains, and some do not. Dr. Delgado has over 25 years of gynecomastia surgery experience, and he claims that by using drains the incidence of complications is very minimal. If drains are not used it is possible that fluid may collect in the “dead space” and will need to be aspirated and maybe more than once.

For most patients, the drains are removed at the first post-operative visit usually within 4 days. When the tube is removed from the surgery site, you may feel a slight burning sensation, but it only lasts a few seconds.

Stay in Touch With Your Surgeon

Dr. Delgado instructs his patients to notify him if any of the following conditions are noted:
• Fever
• The color of fluid is brown, yellow, or green
• A change in the odor of the fluid
• An increase of pain

For any concerns about male breast reduction, call now (415) 898-4161 for an appointment with Dr. Delgado.

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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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.

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.

before and after photo - banner

 

Contact Us For a Free Consultation

To schedule a free 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 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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Dr. Delgado has offices in Marin and San Francisco for your convenience

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