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Category: Gynecomastia recovery

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.

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 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.

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.

Surgery Day! My Gynecomastia Story

Gynecomastia Specialist, Miguel elgado, M.D.

Miguel Delgado, M.D.
Gynecomastia Specialist

In a Patient’s Own Words

You can read reviews, read blogs, research multiple websites, but getting the story of what gynecomastia surgery is like straight from a patient is incomparable! An out of town gynecomastia patient of Miguel Delgado, M.D.’s did just that. The patient documented his surgery experience from his arrival to the hotel through to the third day after surgery.

This documentation may not be state of the art video, but it lends to the authenticity of it! See the video here.

San Francisco gynecomastia patient

Gynecomastia patient

Our patient starts his video with his arrival to his hotel and is describing how he is feeling. Since his surgery is scheduled for later in the day, what seems to be causing him the most anxiety is being hungry! All surgeries that are performed under general anesthesia need to have the patient NPO, which is a Latin term “nil per os” and means nothing to eat or drink by mouth for several hours before surgery to ensure that the patient has an empty stomach. The anesthesiologist will call the patient the day before surgery and review all instructions.

Anxious but Happy!

Our gynecomastia patient describes that besides being hungry, he is anxious and nervous but very happy that he is finally having male breast reduction surgery so that he can get on with his life.

The next topic the patient presents is reviewing all the types of medication that he will be taking. All of the pill bottles are lined up as he describes them. First are his VitaMedica vitamins that he started two weeks before surgery, then he shows his antibiotics and anti-nausea pills that are started just prior surgery and then his pain pills that are for after surgery. Most patients find they only need the pain pills for a day or two.

After taking a shower our patient heads to the surgery center and after his pre-operative preparations he is wheeled into the operating room.

Ready to Live Life

After three days we see our patient again when he is ready to get his drains removed, he is very happy and says he is glad he had his surgery and is ready to live life!

Hopefully, this man’s story will help you make the decision to go ahead with a life changing surgery and once and for all get rid of those man boobs!

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

Planning for Your Gynecomastia Surgery

Gynecomastia Surgery Preparations

Marin Cosmetic Surgery Center

Marin Cosmetic Surgery Center

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

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

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

“Starting Now” includes details on:

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

“The Day Before Surgery” includes details on:

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

“The Morning of Surgery” includes details on:

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

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

Many Medications Must be Avoided

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

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

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

Surgical Risks and Complications

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

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

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

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

Directions to the surgery center with a map are included.

The Importance of Nutrition for Surgery Patients

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

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

Gynecomastia Surgery and the Danger of Smoking

 

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

Some Things Must be Avoided

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

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

No Smoking in San Francisco

Smoking Danger for the Surgery Patient

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

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

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

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

There is Help for the Smoker!

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

Help is a Phone Call Away

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

Gynecomastia Revision is Needed Should I go to the Same Surgeon?

Miguel Delgado, M.D.

Miguel Delgado, M.D.
Gynecomastia Specialist
★★★★★ Ratings: 4.74 -118 Reviews

 

 

 

 

 

 

 

 

 

 

 

Change Surgeons?

This is a good question and needs thoughtful consideration. The answer should depend on what type of revision is needed and why. Highly trained Board Certified Plastic Surgeons that specialize in gynecomastia surgery will explain risks and complications, prior to surgery.

There are Risks

All surgeries come with some risks; the main ones are, infection, bleeding, blood clots, and adverse events related to anesthesia. Although rare, patients need to be aware of the possibility. Additionally and specifically to gynecomastia surgery would be where the original surgeon tried to correct gynecomastia by liposuction alone, without removing breast tissue by surgical excision. Almost all gynecomastia cases need both liposuction and surgical excision; the only exception would be for men that have pseudo-gynecomastia (only fat, and no breast tissue). The second main reason for revision would be; under or over resection of the breast tissue. This would require re-excision for under resection or fat injections or fat flaps for over resection. How complications are managed has a direct relationship to the outcome.

Crater Deformity

Over Resection Causing Crater Deformity

Post Surgery for Crater Deformity

Post Surgery for Crater Deformity

Miguel Delgado, M.D. Gynecomastia Specialist

Miguel Delgado, M.D. has years of experience with revision gynecomastia surgeries, in fact up to 40% of his gynecomastia practice is revision surgeries that come to him from other practices.

If what is needed is a minor adjustment after the initial surgery, such as minimal skin tightening, this should not be considered unusual. If men are not prepared for the possibility of a secondary surgery, it can be very disconcerting, and may cause them to question the capabilities of their surgeon.

Second Opinions Advised

The first step is to have a frank discussion with your surgeon. If you do not feel convinced that your surgeon can correct the issue; it might be of value to get one or two second opinions. Corrective surgery can be very challenging and requires the skill of a gynecomastia specialist. Revision surgery is not as straight forward as the initial surgery, as now the surgeon must deal with scar tissue that has formed from the first surgery and possible loss of some elasticity of the skin.

Contact us!

If you are in need of gynecomastia revision surgery, email (info@dr-delgado.com) or phone (415 898-4161) to meet with Miguel Delgado, M.D. to learn what options are available to you.

“What to Expect the Day of Gynecomastia Surgery”

Miguel A. Delgado, M.D.

Miguel A. Delgado, M.D. Gynecomastia Specialist

★★★★★ Ratings: 4.74 -118 Reviews

Gynecomastia Surgery Center of Excellence

Gynecomastia surgery is not “one size fits all”, each patient is individual and surgery is specific for that patient. However, the surgery process is fairly standard with additional surgery time allowed as needed.

On the day of surgery, you are to arrive 2 hours prior to the start of surgery. You will be greeted by the nurse who will escort you to the “Gynecomastia Surgery Center of Excellence”. You will be assigned a locker where you may store your clothing; all valuables are to be left at home or with the adult who accompanies you.

Pre-operative Preparations

You are then taken to a pre-operative exam room where the nurse will review your post-operative instructions. Dr. Delgado will meet with you to see if you have any further questions and at this time he will be making surgical markings to guide him in surgery.

After Dr. Delgado completes his pre-operative preparations, Dr. Gaynor, a Board Certified Anesthesiologist will meet with you. Dr. Gaynor will have called you the night before to review your

Dr. Randy Gaynor Board Certified Anesthesiologist

Dr. Randy Gaynor
Board Certified Anesthesiologist

medical history and discuss any previous surgeries you may have had. Dr. Gaynor will then start an IV, and you will be going into the operating room shortly. At this point, patients remember very little as the general anesthesia kicks in, and you go into a very comfortable sleep. As you wake up you are happy to find out the surgery is over, and you are wheeled into the recovery room. For standard gynecomastia surgery, the procedure lasts about 3 to 3.5 hours.

Comfortable Recovery

Once in the recovery room, you will be attended by our recovery nurse who will be monitoring your vital signs and making sure you are kept comfortable. Most patients are ready to go home in an hour and a half. For safety purposes, you will be taken down to your car via a wheelchair by the nurse, and released to a responsible adult who will care for you at least 24 hours.

The purpose of this blog is to give you an overview of what to expect the day of surgery. You will be given a detailed instruction booklet at the time of scheduling surgery that will answer many questions. However, Dr. Delgado and his staff are always available to you to guide you through the process with ease.

Contact Information

For any questions or to schedule a consultation with Dr. Delgado, you are invited to call (415 898-4161) or email (info@dr-delgado.com).

before and after photo - banner

 

__ Contact Us For a Consultation

To schedule a consultation with Dr. Delgado in San Francisco, California or Novato in Marin County call 415-830-8883. You may also send us a e-mail at info@DR-Delgado.com or fill out our quick contact form. Send photos of your chest for a complimentary virtual consultation TODAY. We have a complimentary travel package for out of town patients that include travel to and from the airport, four nights stay at the Novato Oaks Inn and travel from the hotel to the office.

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

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450 Sutter Street Suite 2433
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(415) 989-2221

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

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