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Category: gynecomastia

The Best Time to Have Gynecomastia Surgery

 

 

Before and After gynecomastia surgery in San Francisco

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

Considerations For Surgery

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

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

Hiding Male Breasts

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

Enjoy Your Summer

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

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

Call Now!

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

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.

Asymmetry and the Gynecomastia Patient

Gynecomastia is caused when excess estrogen gets stored in the male body which then leads to breast development.

Male Breasts May be Asymmetric

Usually, when a man develops gynecomastia, the breasts are relatively equal in shape and size. However, it is not uncommon for one breast to develop and be larger than the other. In rare cases, it is possible for only one breast to develop. Asymmetry causes men to feel even more self-conscious than men with enlargement on both sides.

asymmetry gynecomastia in San Francisco

This 43 year old man had liposuction in 1992 for his gynecomastia with another surgeon but was not satisfied with the results. Dr. Delgado performed revision surgery, consisting of suction-assisted lipectomy and glandular excision of the chest. Total fat extraction was 350cc from the right side and 375cc from the left to correct his asymmetry.

Some asymmetry is normal, but when it becomes very noticeable, it can be the cause of much embarrassment and shame.

Asymmetry is Corrected by Surgery

The only way to correct asymmetry is by surgery with a gynecomastia specialist. The surgery entails liposuction, surgical excision of the breast tissue with the goal of a masculine contoured chest.

Sometimes asymmetry can occur during male breast reduction surgery by unseen complications or lack of skill by the surgeon. A secondary surgery will be necessary for correction, be sure to choose your surgeon carefully! The patient will need to wait about 6 months before revision surgery can take place.

Dr. Delgado’s Revision Surgery on the Rise

Dr. Miguel Delgado, M.D. states that about 40% of his gynecomastia practice is made up of revision surgery where patients had their surgery done elsewhere. Most revision cases are correction of too much tissue removed (crater deformity) or not enough tissue removed, along with asymmetry.

Call Today!

If you have had unsatisfactory gynecomastia surgery or hope to avoid revision surgery, call now (415) 898-4161 for an appointment with Dr. Delgado who has been performing male breast reduction surgery since 1988.

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 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.

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.

before and after photo - banner

 

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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 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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