San Francisco Gynecomastia
Dr. Miguel Delgado is a world-renowned gynecomastia expert. He has treated thousands of men and boys with this condition. His male breast reduction practice comprises 40% of revision surgeries for men who are unhappy with their outcome from other practices. Dr. Delgado is the owner of Gynecomastia.org, the largest gynecomastia forum in the world. He is dedicated to men and boys who are plagued with this condition.
Gynecomastia is enlargement of breasts on men, giving a feminine look. It can be a psychologically devastating condition for men and boys, known to impair their social development.
Male breast reduction surgery is the fifth most popular plastic surgery procedure done for men in the United States. Thanks to public education, the procedure continues to gain popularity and receptiveness to treatment has become acceptable. Dr. Delgado performs Gynecomastia surgeries at the Marin Cosmetic Surgery Center servicing San Francisco, Marin, Napa and Sonoma County.
Most people are unaware of how prevalent gynecomastia is. The men and boys who suffer with male breasts are extremely embarrassed and will do their best to hide the condition, even to the point of limiting their activities at swimming pools, the beach, and the gym and even in their relationships. Many will try to hide their chests with layers of clothing.
Today, with increasing information provided by the Internet, awareness, education, and opportunity presents itself. Merle J. Yost, LMFT, is the creator of www.gynecomastia.org; Dr. Delgado credits him for his immense contribution in providing the answers people are looking for about this condition. Gynecomastia.org has become the most widely visited forum in the world. When Merle Yost decided to sell the website in 2010, Dr. Delgado purchased it to keep its integrity and high standards.
THE DEVASTATING EFFECTS OF GYNECOMASTIA
Every day is a struggle for the man that lives with man boobs. Each day starts with the unwelcome sight of his chest in the shower, creating a destructive effect on ego and self-esteem. Men have learned to pick their clothing carefully so that they are able to conceal their chests as best they can. Usually they will opt for several layers of clothing such as; shirts with pockets, bulky sweaters, jackets, and dark colors help conceal feminine breasts. Most avoid lightweight fabrics and T-shirts, as they are too revealing.
The locker room at school poses a challenge with, sports activities, swimming, showers, any type of shirtless activities, cause young men to try to avoid such situations entirely.
For men working in a climate controlled environment dictating a shirt, tie and jacket, going to work is not a problem. However, there are many men that have jobs outdoors doing physical labor, which can be miserable if the weather is hot. Gynecomastia sufferers will subject themselves to extreme physical discomfort, in order to avoid the psychological torture caused by teasing and insensitive comments from their peers and co-workers.
Once the day is over, a man will consider it to be a good day if there were no comments about his chest. After the workweek ends, then the men get to deal with; family outings, swimming pools, barbecues, dates, sports and the beach. The gynecomastia sufferer must make special effort to conceal his chest from others. Many times it is easier to avoid the events altogether.
Feelings of shame, embarrassment, guilt, and inadequacy torment men with gynecomastia. It is an ever present burden.
During puberty when hormonal levels of testosterone and estrogen surge, low testosterone or high estrogen, the female hormone, can bring on female like breast tissue. This is the primary cause of gynecomastia.
Another cause of male breasts can be attributed to the use of some drugs, and medications, but especially steroids. Hormone-secreting tumors, although rare, can cause some enlargement. Once men start approaching their sixties, testosterone levels naturally decrease and can result in breast development.
Then there is pseudo-gynecomastia which is not to be considered as true gynecomastia. In this case, fat tissue alone is responsible for the enlargement, and affects many men who have gained a significant amount of weight. If the skin has not been stretched too much, weight loss can reverse pseudo-gynecomastia.
The best treatment is a combination of liposuction and surgical gland excision. Fortunately, this is a highly effective treatment giving the patient outstanding esthetic results. The breast gland is removed through the edge of the areola through an incision about one-half to one-inch long. For some patients, the “Pull-Through Technique” is an option. This is achieved by a small incision of three to four millimeters where the gland is pulled through the opening. The fat and gland components can vary a good deal. Dr. Delgado uses a combination of techniques with liposuction and gland excision.
Research supports liposuction as an effective treatment for male breast reduction; however Dr. Delgado has found from his many years of experience, that when liposuction alone is the treatment, the desired flat chest cannot be realized. Due to the popularity of different types of liposuction such as; laser, ultrasound, Vaser, power-assisted liposuction, and Smart-Liposuction, for removal of the male breast, Dr. Delgado’s gynecomastia practice is now at 40% for revision or redo surgeries for men who had surgery elsewhere and were not happy with their results. These various types of liposuction will not dissolve all the breast tissue needed to be removed to give the optimal results that men are striving for. Both liposuction and surgical excision of the glandular tissue must be performed.
Gynecomastia surgery is considered an outpatient procedure. Dr. Delgado established his own outpatient surgical facility, the Marin Cosmetic Surgery Center, which is federal and state-approved, in 2001. It is located on the campus of Sutter Marin County Community Hospital. Having his own private surgery center allows Dr. Delgado to present to his patients the ultimate level of care in an intimate environment, while in a location adjacent to a full service hospital. Each staff member and surgical team member has been personally chosen and trained to the highest of professional standards by Dr. Delgado with many of his team members having been with him for over ten years. Thus evolved, “The Gynecomastia Center of Excellence”.
DR. DELGADO – THE GYNECOMASTIA SPECIALIST
Indisputably an authority in the surgical treatment of gynecomastia, Dr. Delgado is has focused on this procedure for over twenty-five years having performed more than one thousand male breast reduction surgeries. Dr. Delgado is contacted frequently by other physicians for expert advice and the most difficult cases are referred to him.
It is Dr. Delgado’s personal mission and passion to help men who suffer from gynecomastia; he has developed a website dedicated to focus on the concerns of men with this condition, www.gynecomastia-specialist.com.
Worldwide television documentaries on gynecomastia have featured Dr. Delgado treating patients from all over the world. To enable men to consult with him from around the world, he conducts virtual consultations daily, for both patients near and afar.
FREQUENTLY ASKED QUESTIONS
1. Is there a way to treat gynecomastia without surgery?
Advertised easy, non-surgical cures that are in the news have not been proven to be effective. There is considerable ongoing research to find ways to reverse gynecomastia without surgery, but there is not an effective consistent medical treatment at this time.
2. I want to avoid surgery, is liposuction alone adequate treatment?
Liposuction by itself is a good treatment for pseudo-gynecomastia, but not for true gynecomastia. When liposuction removes the fat around the gland it creates an unnatural bulb which can only be removed by surgical incision. Patients are unhappy with the aesthetic result from liposuction alone. 40% of Dr. Delgado’s male breast reduction cases are redo surgeries from other establishments with most of them due to liposuction alone.
3. During surgery, will the entire gland be removed?
In some cases the entire gland is removed, and sometimes only 80% to 90% will be removed. Gynecomastia surgery is a cosmetic procedure with the aim to create a contoured, flat chest. Dr. Delgado will be happy to discuss all aspects of your procedure with you. In most cases a pathology report is ordered and will be made available to you and it will describe the tissue removed.
4. Can the breast tissue come back after surgery?
In most cases, it will not. However, the tissue can be still stimulated by steroids or other medication usage, and enlarge the breast. If the patient gains weight the amount of fat content will show up on the chest and body. If enough of the breast gland is removed during the surgical procedure, the male breasts will seldom return. Due to continued hormone stimulation, Dr. Delgado has noted that for some adolescent gynecomastia patients that have surgery at a young age, recurrence of their breasts seems to be at a higher rate.
5. Does insurance cover gynecomastia surgery?
Most insurance companies consider gynecomastia surgery a cosmetic procedure. Even the most severe and unfortunate cases including pain and tenderness usually fail to get approval for coverage.
6. Is the surgery painful?
Most patients state that the surgery is not particularly painful. Usually men find they may need pain medication for only two to three days. When the drains are removed, it can be a little uncomfortable, however now it is less so with recent, improved techniques.
7. Will nipple sensation be affected?
There is always a possibility to have a change in nipple sensation with surgery. Most patients do not mention any difference but there have been some that noted a change. The previous owner of gynecomastia.org, Merle Yost, surveyed many men who had gynecomastia surgery with nipple sensation changes as one of the subjects he addresses. You can sign onto the site, www.gynecomastia.org, and read the comments by post-surgical patients about the changes they have experienced with sensation changes of the nipples.
Patients who have had the combination of liposuction and surgical excision, which is the approach Dr. Delgado uses most often, surveyed several of his patients and twenty one reported no change in nipple sensation, with twenty nine saying there was a change. Of the patients that reported a change, two of them said it was an improvement. The twenty-seven patients that reported a loss had a range of 0.5% to 100%, with 37% being the average loss.
This offers some interesting information, but this is just a survey and not a scientific controlled study.
8. What is the cost of gynecomastia surgery?
The complexity of the surgery will determine the cost of male breast reduction. Gynecomastia surgery is not performed under local anesthesia. Surgery at Marin Cosmetic Surgery Center will always be done with a board-certified physician anesthesiologist. When comparing costs, be sure your surgeon and anesthesiologist are board certified and the facility has national and state accreditation as an outpatient surgery center, as does Marin Cosmetic Surgery Center. In general the cost ranges between eight to ten thousand dollars.
9. Are there risks with gynecomastia surgery?
All surgeries come with risks, and that cannot be overstated. One of the most common complications is bleeding under the skin. It used to happen in about 8-9% of patients, but we have improved our techniques and over the past three years we have a lower hematoma rate which is approximately 5-6%. If patients live more than an hour away, we advise them to stay at a local hotel.
Complications are a fact in the practice of medicine. How they are managed is what determines the outcome. With Dr. Delgado vast experience with gynecomastia surgery, he is very comfortable in treating complications.
Another complication is over or under resection of tissue. Under resection is treated with re-excision, but over resection will require or fat flaps or fat injections.
10. How soon can I go back to work?
After surgery, the gynecomastia patient will be able to drive a car in about two to three days, he can return to school or work within a week, unless the work is physically demanding, then two weeks will be needed for recovery. Formal exercise needs to be avoided for four to six weeks.
11. What happens if I am not happy?
Having patients be extremely satisfied with their results is Dr. Delgado’s goal. Dr. Delgado will not charge anything if it is a revision that can be done in the office. Likewise he will not charge a fee for his services, if a procedure needs to be done in the surgery center, but there may be fees for the anesthesiologist and the surgery center.