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Category: gynecomastia

Update on Risperdal, the Drug that Can Cause Gynecomastia

risperdal and gynecomastia

Risperdal Lawsuits Climb

Litigation against Johnson and Johnson (J&J) for their drug Risperdal, had the second highest growth rate for 2016, following Xarelto. Xarelto may be reaching a plateau for new lawsuits, but litigation against J&J has no indication of slowing down. In November 2016, there was a 39% increase with over 15,400 pending lawsuits.

Risperdal is an anti-psychotic drug that was approved by the FDA in 1993 for the treatment of schizophrenia and bipolar disorder for adults. In 2007 the drug was approved for use by children. Along with the stated side-effects, the development of breasts known as gynecomastia was significantly understated. Many physicians were unaware of the complication due to inadequate labeling and therefore were not able to warn parents.

Many of the men who used Risperdal chose to have surgery to get rid of their female type breasts. In order to receive compensation for their surgery and emotional trauma, lawsuits were filed.

Plaintiff Awarded $70 Million

As the trials move forward, the most recent victory went to the plaintiff who had been on Risperdal since he was 5 years old. The jury awarded him $70 million. The Philadelphia jury believes J&J failed to have a proper warning on the label to warn men and physicians of the risk of breast development, even though J&J were aware of the side effect for many years.

J&J will continue to defend each case and have no plans to discontinue Risperdal as they feel it is a “safe” drug, and the benefits outweigh the risks. Even with millions of dollars in awards, J&J considers the payouts just the cost of doing business as the drug brings in billions of dollars in sales each year.

Not all verdicts are in favor of the plaintiffs, one such case in March of this year was tossed out when the treating physician claimed she would have prescribed the drug even with a different warning as she felt the benefits outweighed the risks. This is one of three cases that went in favor of the defendant; however, the plaintiffs plan to appeal.

Future Drop in Sales

As consumers become more aware of the gross negligence by J&J regarding their drug Risperdal, they may eventually see a drop in sales.

Call now!

Dr. Miguel Delgado, M.D. has been treating patients with gynecomastia since 1989 and is an expert in his field. If you are concerned with the development of female type breasts, call today (415) 898-4161 for an appointment with Dr. Delgado for a confidential consultation.

Avoiding Loose Skin After Gynecomastia Surgery

The Doctor's Show

“The Doctors” TV show recently aired an episode featuring a gynecomastia patient who had a BodyTite treatment for male breast reduction. BodyTite is a duel treatment combining liposuction with radio frequency energy that melts fat and tightens skin at the same time.

Intense Marketing for Liposuction

There are many different types of liposuction such as; tumescent, ultrasound, and laser assisted, and each one has multiple catchy names. There has been intensive marketing with inflated claims that make for a lot of confusion for potential patients trying to figure out what treatment would be best for them.

Dr. Miguel Delgado, M.D. has stated that over 40% of his gynecomastia practice is revision surgery for men that have had their original surgery done by another surgeon. Many of these surgeons used liposuction alone and did not surgically remove the breast tissue. Breast tissue is too dense to be removed by liposuction effectively, no matter what is claimed.

The Gold Standard for Gynecomastia Surgery

Liposuction with surgical excision remains the gold standard. For “true” gynecomastia there are no shortcuts. However, patients who have “pseudogynecomastia” which is male breasts caused by fat alone, liposuction can be a good treatment.

Dr. Delgado uses a different technique for skin tightening that gives better results than radio frequency devices. In order to contract the skin, he applies controlled heat directly to the underlying skin (subcutaneous tissue) to avoid surgical excision of loose skin.

Choose Your Surgeon Wisely!

Who does the liposuction is more important than what it is called. Regardless of the type of liposuction used, for “true gynecomastia” surgical excision of dense breast tissue is necessary.

Call today (415) 898-4161 for an appointment with Dr. Delgado who is Board Certified in Plastic Surgery and has specialized in gynecomastia since 1989.

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

Puffy Nipples After Gynecomastia Surgery!

Puffy Nipples in San Francisco

Puffy Nipples                                    After Corrective Surgery

 

Many men complain about puffy nipples after healing from gynecomastia surgery. Liposuction is great for fat removal but will not remove the gland effectively.

Gynecomastia Revision Surgery

Dr. Miguel Delgado, M.D.’s gynecomastia practice consists of about 40% revision cases after surgery performed by another surgeon. Removing the correct amount of tissue and fat from the male breast takes the expertise of a board certified plastic surgeon that specializes in gynecomastia. Many surgeons are very conservative in their removal of tissue to avoid creating a crater deformity. However, when too much gland is left behind, it will push the areola out causing “puffy nipples.”

Crater Deformity in San Francisco

Crater Deformity

After Corrective Surgery

1 Month After Corrective Surgery

 

Gynecomastia patients that have had male breast reduction surgery and end up with puffy nipples are understandably discouraged because their only recourse is a secondary surgery to remove additional breast gland. This revision surgery is a little more complicated due to scar tissue that has formed from the initial surgery.

Choose Your Surgeon Carefully

It is important to choose your surgeon carefully. First, make sure that he or she is board certified in plastic surgery. Secondly, make sure your surgeon has extensive experience with gynecomastia surgery, taking the right amount of fat and tissue is critical to get the precise sculpting for the chest. If too much is removed a crater deformity will be the result, if not enough gland is removed, you will end up with puffy nipples. In both cases additional surgery will be required for correction, it is much better to get it right the first time.

Help is on the Way!

Call now (415) 898-4161 for a consultation with Dr. Delgado if you are suffering from male breasts or are in need of gynecomastia revision.

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.

Preparing for Gynecomastia Surgery

The educational organization, “The American Society for Aesthetic Plastic Surgery,” (ASAPS), is a society made up of board certified plastic surgeons. The society’s purpose is to sponsorscientific meetings presenting the latest developments in cosmetic plastic surgery.

Smart Beauty Guide for gynecomastia

“The Smart Beauty Guide” was created by ASAPS to educate patients and assist in their making of informed choices when it comes to cosmetic surgery. The guide has a section for gynecomastia surgery with pertinent information on all aspects of the surgery. In preparing for gynecomastia surgery, the guide recommends the following:

  • Sun tanning can increase scarring and should be avoided at least two weeks prior surgery.
  • Cigarettes and all nicotine products must be stopped for a minimum of 4 weeks before surgery, nicotine is known to interfere with healing.
  • All supplements and medications that thin the blood must be discontinued at least two weeks before surgery.
  • Staying hydrated before and after surgery promotes healing.
  • If you have any illness or infection before surgery, inform your surgeon.
  • Lab tests need to be done promptly.
  • If your work is labor intensive be sure to allow plenty of time off work for gynecomastia recovery.
  • You will need a responsible adult to take you home after surgery and accompany you for the first 24 hours.
  • Have books, movies, and a laptop available to keep you occupied while recovering.
  • Get all prescriptions filled in advance.

Dr. Delgado’s Gynecomastia Booklet

As a patient of Dr. Miguel Delgado, M.D. you will receive a 40 page preoperative booklet with detailed instructions for before and after male breast reduction surgery. Included in the booklet is an extensive list of all medications and supplements that need to be avoided.

Schedule a Gynecomastia Consultation

Being well prepared before surgery leads to a stress-free recovery. Call today (415) 898-4161 to schedule a gynecomastia consultation with Dr. Delgado.

 

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.

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.

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