Miguel Delgado, MD - title

Stay In Touch


San Francisco, California | Novato, California

Phone 415-830-8883

Blog

« Back to Blog

Category: gynecomastia surgery

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.

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.

Can Breasts Grow Back After Gynecomastia Surgery?

Before and After gynecomastia surgery in San Francisco

                                        Before and After Gynecomastia Surgery

A big concern for some men considering male breast reduction surgery is “will their breasts grow back?” This is a valid concern as it is difficult enough to decide to have surgery only to have the male breasts come back. In most cases, the results are permanent. However, there are instances that “man boobs” may return.

Not All Tissue and Fat Are Removed

True gynecomastia is treated by surgically removing most of the breast tissue and fat, however, some remains to give a sculpted chest and support the areola. It is the small amount that remains that could be a potential problem in the future.

If surgery is done for a young adolescent, male breasts may return because hormones are still stimulating overgrowth. Body builders know gynecomastia is a risk if they use anabolic steroids and they realize man boobs may return if they continue to use steroids after surgery, some choose to use drugs to block estrogenic effects.

Factors That Cause Man Boobs to Return

Patients who frequently use marijuana may find their male breasts return after surgery if they resume use. Another possible factor for breasts returning is if the patient should gain a lot of weight. Even though the fat cells that were removed won’t come back, the remaining fat cells could become enlarged. Other factors that may cause breasts to return could be certain medications or having a hormonal imbalance. Uncommon, but possible is scar tissue buildup.

To determine the probability of regrowth of breasts, finding the original cause can help in preventing recurrence after surgery. The main cause is puberty; but the breasts usually disappear after the teenage years on their own. Besides puberty, the main reasons for male breast growth are:

• Obesity
• Imbalance of testosterone and estrogen levels
• Decrease in testosterone production, common in older men
• Some medications
• Marijuana and other recreational drugs
• Psychological stress

Idiopathic Gynecomastia

If any of these conditions can be treated before surgery, it is recommended to do so to prevent regrowth. Unfortunately, the cause of male breasts is not always known; this is referred to as idiopathic gynecomastia.

The good news is that male breasts do not cause any health concerns but do cause a lot of angst for many men, a high percentage will seek surgical correction. Results are almost always long lasting without recurrence, in all the years that Dr. Miguel Delgado, M.D. has been performing gynecomastia surgery, he has seen very few cases where men have had a recurrence. Dr. Delgado recommends that his gynecomastia patients maintain a healthy lifestyle including exercise and good eating habits.

Call Now!

If male breasts are disrupting your life, call  Dr. Delgado (415) 898-4161 today for a consultation.

Men Worldwide Suffer from Gynecomastia

San Francisco Gynecomastia

This is a 27 year old man who underwent gland excision and liposuction at Marin Cosmetic Surgery Center. He had 350cc of fat and aspirate removed from his right side and 400cc from the left. He is seen here 2 months after surgery.

Scottish Men Have Gynecomastia

Cosmetic Surgery for men in Scotland has been booming. In the last decade, the number of men undergoing cosmetic surgery has doubled. One of the most popular procedures is gynecomastia, up 13% from 2014. The majority are young men who work out at a gym. Also, men who have had significant weight loss and have been left with sagging skin, seek this corrective surgery. Scotland’s largest cities have a growing number of clinics making elective surgery more available for their population.

Gynecomastia in Singapore

There is an article in Singapore that has been published about a man named David (not his real name) who had gynecomastia. David’s story is a common one that we hear in the United States. He had been suffering from man boobs since his early 20’s; he tried to pass it off as nothing but he had physical discomfort in his chest that he could no longer ignore. He thought he might have heart problems, so he sought medical advice which revealed no medical issues.

David then turned to exercise and weight loss, but his man boobs remained, and the pain persisted. By researching online, David suspected that he had gynecomastia. He found a gynecomastia surgeon who confirmed his suspicion. With the support of his wife, surgery was scheduled. David was thrilled after recovery from his surgery, his chest pain was gone, and he now had a masculine chest. He stated that after 20 years he feels like “a real man.” He now encourages other men to seek gynecomastia surgery and not wait 20 years like he did.

Gynecomastia.org is Worldwide

Dr. Miguel Delgado, M.D. recommends to his male breast reduction patients to view the website gynecomastia.org.    Gynecomastia.org is the web’s best resource for information on gynecomastia. The site offers forums for men to share stories and ask questions of fellow forum members, and of member board certified plastic surgeons who specialize in gynecomastia.

Many countries are represented in the forums such as; Canada, the U.K., Asia, Australia, South America, the Middle East, and many more. Gynecomastia.org assists men in finding support and surgeons in their area.

Call Now!

Are you ready to have a normal male chest? Call Dr. Delgado today, (415) 898-4161 for a gynecomastia consultation.

Gynecomastia Consultation Questions

Gynecomastia questions

For men who have hidden the embarrassing condition of female type breasts, making an appointment to see a gynecomastia specialist is a big first step. It is understandable for gynecomastia patients to be anxious and therefore, Miguel Delgado, M.D. recommends writing down all questions as it is easy to forget what you want to ask. However, Dr. Delgado wants his patients to know that he is easily accessible and encourages his patients to call (415) 898-4161 anytime they have a question.

The following questions are some you may want to consider:

1. Is your gynecomastia specialist board certified?
2. Is the anesthesiologist board certified?
3. What type of anesthesia is used?
4. If surgery is to be done at a surgery center, is it accredited?
5. How many years has your specialist been performing male breast reduction, and how many each year?
6. What caused my gynecomastia?
7. How long will my male breast reduction last, and will it come back?
8. How would my surgery be done?
9. Will liposuction alone work for me?
10. Where will the incisions be? Will the scars show?
11. What prescriptions will I need? What are they for?
12. How long after surgery before I can go home?
13. Will I have drains?
14. How long will I need to wear a compression vest?
15. How much time do I need to take off work?
16. When can I start lifting weights?
17. What risks does the surgery have?
18. How are complications handled?
19. Can I see before and after pictures of gynecomastia patients?
20. What is the cost?

Getting answers to all of your questions will ease your anxiety and ensure a positive experience. Dr. Delgado states that the only complaint he has received from his male breast reduction patients is that they wish they had their surgery a long time ago! Start today by calling (415) 898-4161 for your initial consultation!

The Physical Exam for Gynecomastia

 

In a previous blog, details of what to expect during an initial consultation for gynecomastia were reviewed. Click here to read the blog.

To properly diagnose adult gynecomastia a physical exam is necessary. Most exams include the following:
• Exam of the breasts
• Is there any discharge from the nipples?
• Is there an enlargement of lymph nodes in the armpits or the breast?
• Determining if a man’s gynecomastia is “true gynecomastia” or “pseudo-gynecomastia” which is caused by fat alone.
• Assessment of breast tissue
• Checking the size and consistency of the testicles for lumps or asymmetry. Most lumps are benign, but testicular cancer can cause swelling of the breasts.

Physical examination for gynecomastia in San Francisco

Physical Examination for Gynecomastia

When the surgeon does a breast exam, he will have the patient lay flat on his back. The surgeon will bring his thumb and forefinger together on each side of the breast. If the surgeon can feel a disk-shaped mound of tissue behind the nipple and areola, it would indicate “true gynecomastia.” Patients with “pseudo-gynecomastia” will not have such a disk.

Once it is determined what type of gynecomastia is present, the surgeon will then discuss the patient’s options.

Call today (415) 898-4161 to schedule a consultation with Dr. Miguel Delgado, M.D. You’ll be glad you did!

Let Me Get This Off My Chest! Personal Gynecomastia Stories

Before and After Gyneomastia in San Francisco

Before and After Gynecomastia Surgery

Gynecomastia on the Internet

Miguel Delgado, M.D. states that some of the best information you can get on a cosmetic surgery is to hear a patient’s own story. This is especially true for gynecomastia, as men are usually reluctant to talk about their “man boobs.” However, a Google search will show there are many men willing to share their experience in the hopes that they can offer support and encouragement to other men who suffer in silence with gynecomastia.

Lost Weight but Still Has Gynecomastia

For example, there is a posting by a man who tells us how his female type breasts never went away since he was a young man; no matter how much he exercised and how much weight he lost. In fact, he felt his breasts were even more visible as his chest muscles developed when he was working out. He shared how hard it was for him to see a specialist and discuss his condition, but was relieved to find how supportive the doctor and staff were. After he had done a lot of research online, he decided to proceed with surgery, even though he was very anxious. Obviously, he is very thrilled with his results and wrote his story which you can read in its entirety here. Note, he also has a link to his before and after pictures.

Man Boobs and Depression

In another story, a man shares how his man boobs caused him a lot of depression and anxiety, and how he missed out on a lot of activities such as going to the beach or pool, but instead, he spent his time in front of a computer. After suffering for nine years with his female type breasts, he tells us how his male breast reduction surgery changed his life. He did copious amounts of research on gynecomastia, which he shares in his story. See the whole article here.

For many more stories, log on to www.gynecomastia.org, “the Web’s Best Resource for Information”. Click on the tab for “Gynecomastia 101,” then go to “Living With Gynecomastia” and from there go to “Patient’s Stories.”

Take the First Step!

If hearing these stories has helped you make the decision to see a gynecomastia specialist, call now (415) 898-4161 for an appointment with Dr. Miguel Delgado, M.D., who along with his staff will put you at ease and make you glad that you have taken the first step in ridding yourself of your man boobs.

Planning for Your Gynecomastia Surgery

Gynecomastia Surgery Preparations

Marin Cosmetic Surgery Center

Marin Cosmetic Surgery Center

A frequent question that gynecomastia surgery patients ask is: “What do I need to do to plan for my surgery?” Gynecomastia specialist, Dr. Miguel Delgado, M. D. is always happy to hear patients ask this question as their participation is crucial to obtaining the best outcome for their procedure.

Understandably patients are nervous at the preoperative appointment, many times verbal instructions are soon forgotten. Dr. Delgado designed an informative booklet that is presented to all of his patients for reference. However, when in doubt the office and Dr. Delgado are just a phone call away.

The comprehensive booklet of almost 40 pages contains a table of contents divided into sections. Preparing for surgery has directions for; “Starting Now,” and “The Day Before Surgery,” and “The Morning of Surgery.”

“Starting Now” includes details on:

• Cessation of smoking,  multivitamin consumption, aspirin usage, vitamin E limitations, laboratory tests, prescription fills

“The Day Before Surgery” includes details on:

• Confirmation of surgery time, prescriptions, bathing, eating and drinking limitations

“The Morning of Surgery” includes details on:

• Special information, oral hygiene, cleansing, clothing, check in/preparation

The next three pages of the booklet list many medications, supplements and herbal remedies that must be avoided two weeks before and two weeks after surgery. The reason these must be avoided is that they interfere with healing and many slow down blood clotting which can cause complications during and after surgery. Keep in mind this is not a complete list, and any medications or supplements that you take must be cleared by Dr. Delgado. Tylenol is allowed for pain relief.

Many Medications Must be Avoided

Many patients are surprised to see some of the things that need to be avoided. For example, on the list are:

  • Alka-Seltzer, Pepto-Bismol, Vanquish, Sine-off, Sinutab, Motrin, Midol, Actifed, Vitamin E, Raw Garlic, Vitamin-boosted Drinks, Fish Oil, Ginkgo Biloba, Melatonin, Echinacea, St. John’s Wart and many more.

In the next section “Going to Our Operating Facility,” there is a description of the operating suite and the recovery room followed by post-surgery arrangements. Dr. Delgado’s patient coordinator would be happy to give patients a tour of the surgery center.

Surgical Risks and Complications

Included are general surgical risks and complications, and then risks that are specific to the procedure(s), whether it is for a face lift, breast augmentation, gynecomastia surgery or any other cosmetic procedure.

There is a copy of the surgical consent form for the patient’s record.

There are detailed post-operative instructions that include; dressings, drains, compression vest, bathing, ice packs, diet, driving, follow up appointments. Additionally, what the patient can expect as they heal.

Policies regarding insurance coverage, financial arrangements, cancellation and revision surgeries are addressed.

Directions to the surgery center with a map are included.

The Importance of Nutrition for Surgery Patients

Lastly, there is a four page guide that gives detailed information and recommendations on nutrition and the effect it has on wound healing.

Dr. Delgado believes prepared patients have an easier surgery and faster recovery. Call (415) 898-4161 or email info@dr-delgado.com today for a consultation for your desired cosmetic plastic surgical procedure.

Gynecomastia Surgery and the Danger of Smoking

 

Planning for gynecomastia surgery can be an exciting time. To get the best possible results, the patient needs to follow all directions given by their surgeon. Miguel Delgado, M.D. gives all of his cosmetic plastic surgery patients a detailed information booklet to guide them through all pre-operative and post-operative instructions.

Some Things Must be Avoided

There are many important guidelines that need to be followed such as; avoiding blood thinners that can cause complications during and after surgery. The information booklet gives a detailed list of herbs, vitamins and supplements that must be stopped two weeks before and two weeks after surgery.

In addition to avoiding blood thinners, one of the most important warnings given to patients is the mandatory abstinence from smoking. Two weeks before and two weeks after surgery would be the minimum, however, longer or permanently would be better.

No Smoking in San Francisco

Smoking Danger for the Surgery Patient

Many patients who have a hard time quitting smoking may decide a little bit won’t hurt, or if having just one who will know? Cigarettes are incredibly addictive, and it is understandable why patients have such a hard time stopping.

There are several reasons it is imperative that the patient quits smoking before surgery. Cigarette smoke is known to have more than 250 toxins including; carbon monoxide, hydrogen cyanide, nitric oxide and of course nicotine. These toxins all interfere with wound healing.

Oxygen is delivered to the tissues via the blood vessels. Oxygenated blood fights infection and is the means of transport for antibiotics and other medications through the body. Nicotine causes blood vessels to constrict, when this happens it is possible for blood clots to form affecting blood flow to the capillaries. When there is a reduction in blood flow to the tissues, the cells may die causing what is known as necrosis. When necrosis occurs, the surrounding tissue becomes inflamed requiring debridement which is surgical removal. When debridement is necessary, the surgical outcome may be less than optimal.

There have been many studies done showing surgical results between patients who smoke versus the non-smoker. The studies show that smokers are much more likely to develop pneumonia, have a stroke, cardiac arrest or a heart attack. Additionally, smokers need more anesthesia and pain medication.

There is Help for the Smoker!

For a patient not to disclose that fact that they smoke to their surgeon would be a serious mistake, far better would be to enlist the help of your surgeon. Miguel Delgado, M.D. has helped many patients quit smoking by prescribing prescriptions such as Chantix. Remember, Dr. Delgado’s main goal is the safety of his patients so they can move forward with their gynecomastia reduction goals.

Help is a Phone Call Away

For any gynecomastia concerns, call Dr. Delgado today (415) 898-4161 or email info@dr-delgado.com for a consultation.

The Best Source on the Internet for Male Breasts, Gynecomastia.org

gynecomastia.org logo

For years, men have suffered silently with a condition known as gynecomastia. Gynecomastia is the development of male breasts in many men for a variety of reasons. See the June 2015 blog on causes of gynecomastia. It is believed that at least 60% of men develop enlarged breasts at some point in their life and for some it may be permanent.

San Francisco Psychologist Creates Website

Merle Yost, a popular psychologist who treats men with gynecomastia, understands their plight as he had man boobs since puberty. He discovered that there was very little information available to men to help them understand their condition. He counseled hundreds of men but wanted to reach out beyond his practice. He came up with the idea to create an informational website that has no boundaries. Merle Yost contacted Miguel Delgado, M.D. the San Francisco Bay Area’s well-known gynecomastia specialist to collaborate with him in the endeavor. Thus in 1996, Gynecomastia.org was launched.

In 2010, Merle Yost decided to sell the website as the maintenance was too time-consuming for him. Dr. Delgado took over the site to preserve its high standards.

Invaluable Support for Gynecomastia.org Members

There is no cost to become a member of the site, but registration is required. After registering, members are allowed to be interactive on all the forums. The forums are a safe place for men to ask questions of other members without the fear of embarrassment. The support that men find is invaluable; they no longer feel they have to suffer in silence. The members ask and answer questions, share stories, and give recommendations. They also can ask questions of gynecomastia surgeons who frequent the forums. The surgeons who are members of the site do pay a fee that helps offset the costs of maintaining the site.

Gynecomastia.org offers more than the forums, additionally, there are hundreds of before and after pictures of patients that have had male breast reduction surgery, there are videos, and a directory that lists gynecomastia surgeons in most states, and even outside of the country. You will also find news articles and a blog page.

Through the years, Gynecomastia.org has gained immense popularity, proving the site fills a great need. All the major search engines have the site close to the top of their first page.

Call Today for a Gynecomastia Consultation With Dr. Delgado

Men who have seen Dr. Delgado in consultation comment how comfortable he makes them feel, his compassion about their condition is obvious. Dr. Delgado’s surgical patients say their only regret is that they did not come and see him sooner!

If you have been putting off a consultation due to embarrassment or shame, you have found the right surgeon. Call today for an appointment with Dr. Delgado at (415) 898-4161 or email info@dr-delgado.com.

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.

Contact Us

Please feel free to fill out the form below for a price quote or to contact us with any questions or comments you may have.

  • This field is for validation purposes and should be left unchanged.

Dr. Delgado has offices in Marin and San Francisco for your convenience

San
Francisco

line-border - pic

450 Sutter Street Suite 2433
San Francisco, California 94108
(415) 989-2221

[ DIRECTIONS ]

Marin
County

line-border

165 Rowland Way Suite 300
Novato, CA 94945
(415) 898-4161

[ DIRECTIONS ]

travel package - banner
website - picture
Top