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Category: gynecomastia

Gynecomastia Surgery, Where Will Your Incisions Be?

Gynecomastia surgery in San Francisco

                                    Before and After Gynecomastia Surgery

Deciding to have male breast reduction surgery is only the first step in achieving a nice contoured chest. Picking just any surgeon who states that they do gynecomastia surgery might be a big mistake. Selecting a board certified plastic surgeon can also be a mistake.

A Gynecomastia Specialist is a Must!

Choosing a board certified plastic surgeon is essential, but you must go further and determine if the surgeon specializes in man boobs. Ask how many male breast reduction surgeries are done each year and view many before and after pictures.

Ask the surgeon if you have breast tissue and fat. This can be determined by a physical exam. If you only have fat, it will feel soft, but if there is breast tissue present, it will feel firm. The majority of men have “true” gynecomastia which is a combination of fat and breast gland.

True Gynecomastia Requires Excision

If you have “true” gynecomastia, ask the surgeon during your consultation, if you will be having liposuction and surgical excision of the breast tissue. If surgical incision is going to be done, ask where the incisions will be. You want to hear that the tiny incisions for the liposuction cannula will be high up in the armpit so that when it heals, it will be undetectable. You also want to hear that the incisions for the surgical removal of the breast tissue will be around the bottom half of the areola. The incision around the areola once healed will be barely visible.

Extreme Gynecomastia, 2 Stage Surgery

There are exceptions to this, and that would be for the man that has extreme gynecomastia and may need his surgery done in two stages. However, with proper planning, the second stage incisions are to be done around the areola, but fully around the areola, removing a donut shape of excess skin, and then closed with purse string sutures. Note at two weeks post op the patient below, when fully healed the incisions will be barely detectable.

gynecomastia first stage

    Extreme Gynecomastia

Gynecomastia, First Stage After 6 months

Six Months After First Stage

gynecomastia two weeks after second stage

Two weeks after second stage

If you have “true” gynecomastia and the surgeon tells you that the fat and breast tissue can be removed by liposuction alone, this should be a red flag for you. Dr. Miguel Delgado, M.D.’s gynecomastia practice is at 40% for revision surgery. Most of the revision cases are to correct surgery where only liposuction was done. If the male breast is only fat, it is referred to as “pseudo-gynecomastia” and liposuction alone is a successful procedure.

Horizontal Mastectomy Incision

Some surgeons use a horizontal mastectomy incision for male breast reduction. Dr. Delgado finds this unacceptable, he feels the resulting scars are as bad as the condition that is being corrected.

After gynecomastia surgery

Horizontal Mastectomy Incision

Having decided to proceed with surgery, do your homework and ask lots of questions of your surgeon. Get more than one opinion if you have any doubts. Revision surgery is expensive and should be unnecessary.

Call Now!

For a consultation with Dr. Delgado, call (415) 898-4161.

 

The Birds and the Bees and Gynecomastia, Talk to Your Sons!

gynecomastia surgery in San Francisco

                                     Before and After Gynecomastia Surgery

Answering Your Children’s Questions

Talking about the “birds and the bees” with children is something that makes many parents uncomfortable. Parents need to decide how they will answer children’s questions. There are many self-help books and programs to help guide parents through tough questions. Children need to be prepared for changes as they go through puberty.

Wise parents will start early in discussions about puberty with their children. Using a matter of fact tone with age-appropriate information, is better than letting them hear stories from other kids, television, or other inappropriate sources. 

Adolescent Gynecomastia is Normal

As boys approach puberty, they may be excited to note that their voice is getting deeper and maybe getting new hair where hair didn’t grow before. They may be happy to see facial hair and can start shaving like Dad. However, there are more changes, up to 70% of boys may begin to develop breasts as they go through puberty, a condition known as gynecomastia.

Adolescent gynecomastia is a normal result of hormonal changes. Left untreated it will usually resolve itself within a few months up to 2 years. If boys aren’t aware that this is a normal phenomenon they may be terrified to see breasts appear on their chests. Most feel great shame and embarrassment and will try to hide their chest. They may be teased mercilessly from classmates, causing withdrawal from social activities. Usually, boys are too embarrassed to talk to their parents. Parents may be totally unaware that their son is suffering. Unfortunately, many parents are not familiar with gynecomastia.

Prepare Your Sons!

Today with the advent of the internet, information is readily available, and hopefully, the mystery of gynecomastia is a thing of the past. Parents need to prepare their sons of the possibility they may temporarily develop breasts before it happens.

If your son is having a hard time coping, it would be wise to seek a consultation with a board certified plastic surgeon that specializes in gynecomastia. Dr. Miguel Delgado, M.D. advises parents that in some cases male breast reduction surgery is available for young men, especially when it is affecting them psychologically.

Call Today!

If you have a son who is struggling with male breasts, call now (415) 898-4161 for an appointment with Dr. Delgado and learn what options are available.

Gynecomastia May Indicate a Serious Health Condition

Before and After gynecomastia surgery in San Francisco

                                           Before and After Gynecomastia Surgery

For the majority of men with gynecomastia, having male breasts are mostly a benign condition and pose no health concerns. But, the psychological impact can be devastating and impact self-esteem.

Gynecomastia and Health Concerns

However, some serious health conditions may cause gynecomastia; men with moobs should seek medical evaluation.

Some of the serious conditions known to cause gynecomastia are:

• Liver disease

The liver has many functions including clearing excess hormones from the body. If there is liver damage and estrogen is not metabolized correctly, it can lead to the development of breasts in men.

• Kidney Disease

Hormonal imbalance can occur with impaired renal function. With decreased testosterone and an increase of estrogen, man boobs may result. A kidney transplant can reverse the problem, but some drugs used after a kidney transplant may cause men to have breast development.

• Malnutrition

Prolonged starvation can cause temporary moobs. When malnourished men have lower testosterone, some systems increase function before others when a man returns to a normal diet. This phenomenon was noted when World War II prisoners of war came home.

• Male Hypogonadism:

When the testicles don’t produce enough testosterone the ratio to estrogen will be skewed with the probable result of man boobs. This could be a problem with the testes, the pituitary gland, or the hypothalamus.

• Human Chorionic Gonadotropin (hCG)

If a man has gastric carcinoma, large cell carcinoma, or renal cell carcinoma, his hCG levels won’t be normal, and moobs may form.

• Increase of Cortisol Levels:

Your adrenal glands make a steroid hormone called cortisol. Cortisol helps the body respond to stress, fight infections, and regulate blood sugar. Men experiencing a lot of mental stress may have excess cortisol in the body. Men with increased cortisol and estrogen, along with low testosterone will very likely have the development of male breasts.

Dr. Miguel Delgado, M.D. states there are more conditions can lead to the development of man boobs. As mentioned before, gynecomastia is mostly a benign condition but it can be an indication of other health issues and should be evaluated.

Don’t Wait, Call Now!

For any gynecomastia concerns, please contact Dr. Delgado at (415) 898-4161

 

Estrogen is in Your Food!

Estrogen in Food Causes Moobs

                                         Before and After Male Breast Reduction Surgery

Men’s body naturally produces estrogen, the “female hormone,” but in a much smaller amount than for women. When estrogen and testosterone are perfectly balanced, the body works as it should. However, Dr. Miguel Delgado, M.D. warns that several factors can unbalance the ratio of hormones that will lead to unwanted side effects such as infertility, erectile dysfunction, and gynecomastia.

Change Your Eating Habits

It is possible for men to lower their estrogen levels by changing their eating habits. If caught early, by avoiding some foods that are high in estrogen, they may be able to reverse some feminine characteristics they may develop before they become permanent.

Estrogen Rich Foods to Avoid

Soy – known as phytoestrogens (plant produced estrogen). This includes soy milk, protein drinks, protein powder, and in thousands of packaged foods. Read the labels! Most grocery store foods that contain soy are genetically modified (GMO). More than 90% of soy grown in the United States is (GMO). However, the traditional crop grown in Japan is not GMO. Miso, natto, and tempeh are fermented soy products and are the safe for consumption.
Sugar and Carbohydrates – Both are highly processed, and in addition to the adverse health effects, they cause the body to produce more estrogen.
Conventional Meat and Dairy – Milk may contain up to 20 medications and growth hormones. Growth hormones are given to cows so that they will produce more milk and grow faster. Look for milk that is organic or labeled “bGH-free.”

Beware of BPA!

When cleaning up your diet, you should also be aware of Bisphenol A (BPA). BPA has been around since the 1960’s and is an industrial chemical often used in the production of plastic water bottles and food containers. BPA mimics the hormone estrogen. Research has shown BPA can leach into beverages or food and cause health issues. Avoid water bottles that have been exposed to heat and foods that are microwaved in plastic containers.

Detox Your Body

You can start to detox your body by avoiding the listed foods and products and add cruciferous vegetables like cauliflower, broccoli, cabbage, Brussel sprouts, kale, etc. You can also increase your probiotic and prebiotic consumption through supplements or fermented foods like sauerkraut, kombucha, and kimchi.

Call Now!

If your breasts are starting to feel tender or painful do not wait, call (415) 898-4161 for an appointment with Dr. Miguel Delgado, M.D.

Moob Surgery and Reasonable Expectations

unilateral moob in San Francisco

22 year old male presents for unilateral right gynecomastia. Hormone testing proved normal. He had gland excision on the right with liposuction. He is seen here 4 weeks post op.

 

No one has a perfect body, most men carry some extra weight, some are barrel-chested, or some may have a somewhat concave chest. Like women, a lot of men may have one breast larger than the other. It is unknown why some people have more of a propensity to form scar tissue than others. All of these factors can contribute to moob surgery results.

Moob Surgery Complications are Rare

Complications are infrequent, but when they do occur they usually are minor, and most can be treated as an office procedure. However, all surgeries come with some risk such as:

• Bleeding (hematoma)
• Blood clots
• Infection
• Adverse reaction to anesthesia

Specifically for gynecomastia, there can be pigment changes, some asymmetry of the breasts or nipples, loss of sensation or numbness in the nipples which is possible to last up until a year, rarely is it permanent.

Under or Over Resection

Men who are seeking gynecomastia revision surgery usually have not had enough tissue and/or fat removed; this is referred to as “under resection.” Under resection is a common outcome when the surgeon only uses liposuction for moob reduction. Another complication is “over resection” where too much fat and tissue has been removed, also known as a “crater deformity.”

In some instances, men complain that a few weeks after surgery they have “puffy nipples” for most, this is due to the development of scar tissue which generally takes a few weeks to develop. Many times the scar tissue can be resolved with steroid injections done in the office.

Common Conditions After Moob Surgery

Dr. Miguel Delgado, M.D. states that after the trauma of surgery, moob patients will find that there will be swelling, and bruising, but when, where, and how much can’t be determined. Additionally, scar tissue will form, but again how much can’t be predicted.

After obsessing about their man boobs for a long time, some men will be looking for perfection. Plastic surgery is not a perfect art; however, significant improvement can be expected.

Find an Experienced Moob Surgeon

In the hands of an experienced board certified plastic surgeon that specializes in gynecomastia, many steps can be taken to assure a great outcome. A general surgeon and even some board certified plastic surgeons do not have the skills that a gynecomastia specialist has for a very complex surgery.

It is the expert gynecomastia surgeon who understands possible complications and how to treat them.  This is the surgeon who does 100’s of male breast reductions surgeries a year, not just a few. View many before and after pictures and select a surgeon with impressive results.

Call Now!

Dr. Delgado has 100’s of before and after pictures available for viewing, call today (415) 898-4161 for a consultation.

 

Massage After Gynecomastia Surgery

Massage for Gynecomastia patients in San Francisco

Scarring can be very unpredictable, and no two patients will heal the same. As the body recovers after gynecomastia surgery, there will be scar tissue forming both internally and externally. Sometimes the scar tissue may feel lumpy, and some men are fearful their man boobs are returning. This scar tissue is not breast tissue and will not affect the overall appearance.

Scar Tissue After Gynecomastia Surgery

Scar tissue will not disappear if it is massaged, but there are benefits to be gained, Dr. Miguel Delgado, M.D.  has his patients start a gentle massage after about 3 weeks as long as it is not painful. To start massaging before then may cause unwanted swelling.

 

The Benefits of Massage

The skin may feel hypersensitive as healing takes place and sensation starts to return. Massage may reduce the sensitivity. In addition, massaging can help the body get rid of pockets of fluid and reduce swelling. Massage may help internal scarring to be looser and more flexible. Massaging external scars with a lubricant may prevent scars from cracking and drying out.

How to Massage

If you are instructed to start massaging, the way to do it is; raise one arm over your head, take the three middle fingers of the opposite hand and gently use a circular motion on areas that feel firm. Gradually increase the intensity, but not to the point that it hurts. Massage for about 5 minutes on each side two times a day.

Options for Scar Revision

It isn’t possible to avoid scar formation after surgical procedures. However, there are treatment options available to reduce scar tissue such as; steroid injections, or even a minor scar revision surgery.

Do not attempt massaging your chest unless directed by your surgeon.

Call Now!

For additional information for any gynecomastia concerns, call today (415) 898-4161 for an appointment with Dr. Miguel Delgado, M.D.

 

Gynecomastia Surgery, Sometimes a Two-Stage Procedure

 

For men with moderate to severe gynecomastia, a different approach for male breast reduction surgery is required. Older men who have lost elasticity of their skin or have had a massive weight loss of 100 to 200 pounds may have a tremendous amount of loose skin. Some surgeons will opt for a mastectomy type surgery where removal is done in one procedure. However, Dr. Miguel Delgado, M.D. tries to avoid this as he feels the resulting scar that goes across the chest is almost as disturbing as the large breasts

Gynecomastia Specialist, Dr. Miguel Delgado

A gynecomastia specialist, Dr. Delgado has been performing gynecomastia surgery since 1988. Dr. Delgado believes the way to get the best surgical result for a man with severe gynecomastia is to do male breast reduction surgery in two stages.

Stage One

The first stage is done with aggressive excision of the breast tissue along with liposuction. If the patient doesn’t have a lot of loose skin, a crescent lift may be done. A crescent lift is where a half donut shaped piece of skin is excised above the areola that reduces sagging and the lower fold. For some patients, the result is such that they may choose not to have a secondary procedure, but the scar will be  more visible at the top of the areola.

gynecomastia first stage

Extreme Gynecomastia

For more severe cases such as the one pictured here, a secondary procedure is scheduled after four to six months after the first stage.

Stage Two

Gynecomastia, First Stage After 6 months

Six Months After First Stage

The secondary procedure is the periareolar lift. The periareolar lift removes a donut of skin completely around the areola. After healing, the incision will blend into the areola extremely well.

Post Op at Two Weeks

gynecomastia two weeks after second stage

Two weeks after second stage

Call now (415) 898-4161 for a gynecomastia consultation with Dr. Delgado.

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.

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