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Category: Gynecomastia results

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.

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.

“Adolescent Gynecomastia Treated in One Stage”

Miguel A. Delgado, M.D.

Miguel A. Delgado, M.D.

 

 Gynecomastia to the Extreme

★★★★★ Ratings: 4.74 -118 Reviews San Francisco, CA-Men with severe gynecomastia, who choose to have male breast reduction surgery, will find that they most likely will need their surgery done in two stages. Dr. Delgado found that by dividing the surgery into two stages that he could minimize the scarring that more aggressive one stage surgeries, performed by other surgeons, usually causes.

Two Stage Gynecomastia Surgery

Viewing the patient below, you can see how removing a tremendous amount of tissue and fat leaves a lot of loose skin and a breast fold, making the results for most men unacceptable.

Before and After Stage One Gynecomastia Surgery

Before and After Stage One Gynecomastia Surgery

Once the patient has healed from the first stage, after about 5 or 6 months, the second stage can be scheduled. The second stage is much easier than the first stage and can be done as an office procedure under a local anesthetic. During the second stage surgery, Dr. Delgado removes the excess skin in a donut shape around the areola. The closure is with purse string type sutures. The third picture of this patient shows the amazing results just two weeks after surgery.

2 Weeks After Stage Two Surgery

2 Weeks After Stage Two Surgery

There is a huge advantage for men to have gynecomastia surgery at a young age because the skin has a lot more elasticity.

One Stage Gynecomastia Surgery for Adolescents

The following pictures show a boy of 15 years of age who traveled with his parents from the East Coast of the United States to have surgery with Dr. Delgado. Due to the excellent quality of his skin, his surgery was completed in one stage.

Before Stage One Gynecomastia Surgery

Before Stage One Adolescent Gynecomastia Surgery

Recently his Mother sent a picture of her son one year later. She states how well he is doing and how thrilled they are with his results.

After Stage One Adolescent Gynecomastia surgery

After Stage One Adolescent Gynecomastia surgery

If an adolescent has gynecomastia surgery but hasn’t finished developing, there is a possibility that there may be additional breast growth. For all the years that Dr. Delgado has been performing this surgery, he has not had the need to re-operate on any of his patients. It is imperative when seeking a surgeon that you choose a Board Certified Plastic Surgeon that specializes in gynecomastia surgery to be able to evaluate a young man’s options.

Contact Dr. Delgado Today!

If you or someone close to you is suffering from large male breasts, call (415 898-4161) or email (info@dr-delgado.com)today for a consultation with Dr. Delgado.

Gynecomastia Surgery Redo Now at 40%

 

pics Male patient before and after Gynecomastia Surgery

This 49-year-old man had gynecomastia surgery twice with other physicians. He sought my help wanting to undergo a third procedure as he was still unhappy with his result. He underwent glandular excision and suction-assisted lipectomy of the chest.

San Francisco, California-On August 17, 2010, I published a blog “Liposuction for Gynecomastia”. At that time,  I stated the percentage of redo surgeries that were originally done by other surgeons was at 25% to 30%.

Today, the percentage of redo male breast reduction surgeries in my practice has increased to 40%! This is due to the same reason as before. There are many surgeons that believe the desired results of a well sculpted male chest can be attained by liposuction alone. When liposuction alone is used, breast tissue remains and it can actually look more prominent than before the fat was removed.

True gynecomastia is a combination of fat and breast tissue. The fat can be removed very well by liposuction; however, the breast tissue is too dense to come through the cannula. Breast tissue needs to be removed by excision, and it needs to be done by a gynecomastia specialist who has the expertise to give a masculine contour to the chest.

If the breast tissue is removed too aggressively, the result can be a crater deformity, another cause for redo. This is an extremely frustrating situation for the man who has finally had surgery to correct his moobs. The good news is that almost all of these cases can be corrected, but just emphasizes the fact that men need to do their homework in picking a Board Certified Plastic Surgeon for gynecomastia reduction surgery. Ask a lot of questions, request to see before and after pictures, ask how many male breast reduction surgeries are performed each year, you want to be sure to pick a gynecomastia specialist so that a gynecomastia redo surgery will not be necessary. A good source for Board Certified Plastic Surgeons is www.gynecomastia.org.

 

Crater Deformity - image

Crater Deformity

 

After Surgery for Crater Deformity Correction - pic

After Surgery for Crater Deformity Correction

What Procedures Can be Combined With Gynecomastia Surgery?

gynecomastia patient with liposuction

This 55-year-old man suffers from adolescent gynecomastia. He underwent glandular excision and suction-assisted lipectomy of his chest, flanks and abdomen. From the right flank, I removed 1325cc of total fat, 1175cc from the left flank, 2650cc from the abdomen, 475cc from the right side of the chest and 450cc from the left side, bringing the total amount of fat removed to 6075cc.

 

San Jose gynecomastia patients ask if they can combine more elective surgical procedures to their gynecomastia surgery. Combining procedures is very common, most popular is the addition of more liposuction to the abdomen, love handles or lower armpit area and/or back. Having a secondary surgical procedure saves money and the recovery time will be the same. Adding areas of liposuction to the upper torso gives Dr. Delgado the ability to get a more sculpted result.

Due to busy work schedules, it is not unusual for some San Francisco Bay Area men to ask if unrelated cosmetic plastic surgeries can be done at the same time as their male breast reduction surgery, and the answer is “absolutely!” Today longer procedures are quite common and considered extremely safe due to advances in anesthesia and surgical technique. Marin Cosmetic Surgery Center has all state of the art equipment and a highly trained staff allowing patients to combine such surgeries as eyelid surgery to their male breast reduction surgery. Each patient is different, and a personal consultation is necessary to determine how much surgery can be done at one time. In addition to getting an outstanding surgical result, safety is the main concern for each patient. At the time of the initial consultation, Dr. Delgado is happy to discuss all surgical desires of his male breast reduction patients.

After Gynecomastia Surgery, How Visible are the Scars?

drain-scar - photos before and after

Scar from drain before new technique

For the San Francisco Bay Area man, in order to remove male breast tissue and fat during male breast reduction surgery, an incision is made at the bottom half of the areola, between the darker and lighter skin. When it heals it is almost invisible. Chest hair can also help in hiding the incision.The healing process can take up to 6 months to a year.

I recommend silicon sheeting about 10 days after the incisions are healed. Silicon sheeting helps soften and lighten the color of the scar. I also do a tiny incision in the armpit for the liposuction cannula and for the drain.

My San Jose patients let me know that the tiny scar left by the drain under the arm was a point of concern, now by a new technique I place it high up in the armpit toward the back, most of my patients have a hard time finding it.

Depending on the severity of the gynecomastia breast determines the incisions, sometimes it can be less, in some cases it can be more if a second stage reduction is needed.

How Will I Look After Gynecomastia Surgery?

 

male breast reduction surgery before and after

Before and After Gynecomastia Surgery

A big concern of San Francisco Bay Area men contemplating male breast reduction surgery is what they will look like after surgery. There isn’t a “one size fits all” answer. Each patient is different, depending on the degree of the gynecomastia breast. Age can be a factor, younger men usually have better skin contraction. Men with moderate to severe gynecomastia, may need to have a two stage procedure for the best result.

During the consultation, it is not unusual to hear a man request that his chest be made as flat as possible. This is understandable for the man that has been suffering with man boobs for many years. A totally flat chest does not look normal, it is important that it is sculpted and has somewhat a natural contour. Dr. Delgado shows his patients many before and after pictures; he does his best to accurately describe what the outcome will be for each individual patient.

Recovery from Moob Reduction Surgery Faster with Vitamins

Dr. Delgado observed that his San Francisco moob reduction surgery patients that were on high quality vitamins appeared to have a faster recovery than those who did not. For years, Dr. Delgado encouraged his patients to take vitamin supplements both before and after surgery. He pointed out that they needed to find a vitamin that did not contain vitamin E as it is a blood thinner and impedes the healing process. Patients found it difficult to find a vitamin that did not contain vitamin E. After much research, Dr. Delgado found VitaMedica to meet and exceed his requirements.

VitaMedica Surgery Support - pic

VitaMedica Surgery Support

VitaMedica has a Surgery Program of products designed specifically for the surgery patient. It not only has high quality vitamins that do not contain vitamin E, they also contain higher amounts than normal of vitamin C, which is recommended for the surgery patient. In addition to the vitamins, the program contains Bromelain with Quercetin that reduces bruising and inflammation, and Arnica Montana, which has been shown to reduce discomfort, swelling and bruising. The supplements are to be taken two weeks before surgery and two weeks after, discontinuing all other supplements while on the program.

Encouraged by the results of his gynecomastia surgery patients that take VitaMedica, Dr. Delgado now includes the Surgery Program for all of his surgery patients.

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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