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Category: gynecomastia surgery

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!


Castle Connolly Selects Dr. Miguel Delgado Top Doctor Again!

Castle Connolly Top Doctors

Castle Connolly Medical Ltd. Publishes a variety of books and guides to help consumers find the best in healthcare. This is invaluable information especially for people who are new to an area. The most popular book they put out is “America’s Top Doctors.” In addition to the books, Castle Connolly has a website directory.

Castle Connolly Selects Top Doctors

Thousands of American physicians are surveyed. The doctors are carefully reviewed by Castle Connolly research team. Some things the team considers are; education, residency, fellowships, board certifications, professional reputation, and much more. The selected doctors are considered the best in their specialty. Doctors cannot pay to be included in the directory, nor can they nominate themselves.

Castle Connolly Medical, Ltd. was launched in 1992 by two professional leaders in healthcare. John K. Castle was a member of the Board of New York Medical College for 22 years, and Chairman of the Board for 11 years. Dr. John Connolly was President of New York Medical College for over 10 years.

Media Recognizes “America’s Top Doctors”

Many major media outlets have recognized “America’s Top Doctors,” to name a few:

  • Good Morning America
  • 20/20
  • Morning News
  • Fox Cable
  • 48 Hours
  • Weekend Today in New York

Multiple newspapers include:

  • Chicago Tribune
  • Boston Herald
  • Daily News
  • New York Times

Popular magazines include:

  • Town & Country
  • Redbook
  • Fortune
  • Money
  • Atlanta Magazine
  • And many more

It is possible for physicians to be removed from the list. They may be removed if; they retire, are unavailable to patients, take a full-time administrative post, have any mal-practice or disciplinary issues, negative feedback from patients or physicians.

Finding Your Gynecomastia Specialist

For patients searching for a gynecomastia surgeon, “America’s Top Doctors” is a good start. In addition to confirming your surgeon is Board Certified in Plastic Surgery, be sure the surgeon is a gynecomastia specialist. Ask to view before and after pictures of the surgeon’s male breast reduction patients.

Castle Connolly Selects Gynecomastia Specialists

                                          Before and After Gynecomastia Surgery

Dr. Miguel Delgado, M.D. has been performing gynecomastia surgery since 1989, and is considered one of the very top gynecomastia specialists in the United States and the world. Patients travel great distances to be treated by Dr. Delgado.

Dr. Delgado offers assistance to out of town patients to make their travels worry-free. He arranged a discount at a nearby hotel that includes free shuttle service to the office.

Make an Appointment Today!

Call now (415) 898-4161 to schedule a consultation with Dr. Delgado to discuss any gynecomastia concerns you may have.


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.

Will Liposuction Alone Remove “Man Boobs?”

Liposuction and Gland excision Surgery in San Francisco

                                                      Before and After Gynecomastia Surgery

There are several different types of gynecomastia with varying degrees of severity. The amount of fat versus breast tissue varies greatly. Gynecomastia patients must be evaluated on an individual basis. Often the ratio of fat to breast tissue can’t be determined until surgery, and that will determine the surgical approach.

Liposuction Will Not Remove Breast Gland

Men with gynecomastia who research their options are lead to believe that liposuction alone may be their solution. Unfortunately, many plastic surgeons agree with this treatment. There are many different types of liposuction machines available today. Many surgeons claim they can remove fat and breast tissue with liposuction. However, no energy device can remove breast tissue that is found in almost 80% of gynecomastia patients. Breast tissue must be removed by surgical excision.

A small percentage of men have what is referred to as “pseudo-gynecomastia.” Pseudo-gynecomastia is where the male breast is almost all fat. For these men, liposuction is a great treatment. It is possible for these men to reduce their male breasts if they lose weight. If they are struggling with weight loss, liposuction or even CoolSculpting may be the answer. But men, who have breast tissue left behind after liposuction, will find they now have what is referred to as “puffy nipples.”

Liposuction May Leave Puffy Nipples

Puffy nipples are caused by breast tissue that remains behind the nipple. Without the fat as a buffer, the nipples protrude even more than before surgery. When researching gynecomastia surgery, check out unhappy patients who are seeking revision surgery on RealSelf.com and Gynecomastia.org.

Dr. Miguel Delgado, M.D. has been performing gynecomastia surgery for almost 30 years. He states that about 40% of his gynecomastia practice is revision surgeries, and most of them are for patients who had liposuction alone.

Make an Appointment Today!

Contact us now (415) 898-4161 for a consultation with Dr. Delgado for any male breast issues you may have.

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 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.




Body Builders, Gynecomastia, and Performance Enhancing Drugs

Body builders and gynecomastia surgery, before and after

Treatment for body builders with gynecomastia is usually different than for other men. Body  builders usually do not have excess fat or skin. Body builders may be at higher risk for bleeding complications due to highly developed chest muscles that allow an increase in blood flow. Fish oil, certain vitamins and some protein shakes contain blood thinners that need to be stopped before surgery as they can increase the risk of bleeding.

Body Builders May Develop Breasts

Not all body builders will develop gynecomastia; there is no way to determine who will. However, if as young men they had adolescent gynecomastia, they are at greater risk.

Anabolic steroids continue to be popular with many men wanting to build muscle mass, but they find that they may start to develop breasts due to the high content of estrogen; some men can even begin to lactate. Other side effects of taking steroids include, painful erections, shrinking of testicles, decrease in sperm count, infertility and impotence. Anabolic steroids require a doctor’s prescription for a medical condition. Doctors are not allowed to prescribe steroids to enhance athletic performance.

Estrogen Blockers Bought on the Black Market

Many iron pumping weightlifters take the breast cancer drug Nolvadex, which is the generic form of Tamoxifen, which is used to counteract the continued use of steroids. Nolvadex is an estrogen inhibitor but requires a prescription and is used for the treatment of breast cancer. Social media such as Facebook has become a source for finding black market prescription drugs. However, there are many side effects associated with the drug such as; nausea, vomiting, hot flashes, numbness, blurred vision, leg cramps, thinning hair, reduced sexual interest, impotence, skin rash, risk of blood clots, cataracts, and depression.

Sadly many men will do whatever it takes to be bigger and stronger even if it shortens their life span.

Stop Steroids to Stop Breast Growth

Many body builders want to have all of their breast tissue removed so that they can continue to take steroids and avoid recurrence of breast tissue growth. However, Dr. Miguel Delgado, M.D. states that some breast tissue needs to remain for contouring or the chest will have an unnatural appearance. Dr. Delgado encourages men to discontinue the use of steroids and estrogen inhibitors and enjoy the natural look of their chest after male breast reduction surgery.

Call Now!

Call today (415) 898-4161 for a gynecomastia consultation if you are unhappy with your chest.

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450 Sutter Street Suite 2433
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165 Rowland Way Suite 300
Novato, CA 94945
(415) 898-4161


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