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Wednesday, June 21, 2017

Performance Enhancing Drugs and Gynecomastia

Body Builder's and Gynecomastia

Body builder’s treatment for gynecomastia will be different than for other men due to their lack of fat and excess skin. They do have a higher risk of bleeding complications because their chest muscles are highly developed which allow for an increase in blood flow. They will be warned to stop taking products that contain fish oil, vitamin E and some protein shakes that have blood thinners to avoid bleeding issues.

It is not possible to determine who will develop gynecomastia, but for body builders that had adolescent gynecomastia, their risk is higher.

Some men will do anything to make more muscle mass, even if it shortens their life span. It is against the law for body building purposes, but many take anabolic steroids, knowing there are risks and many side effects. One of the main side effects is the development of female type breasts. In order to counteract the additional estrogen, sometimes estrogen blockers such as Tamoxifen is taken. However, Tamoxifen is a treatment for breast cancer and also is not allowed to be prescribed for body building purposes. Due to its popularity, men can find ways of obtaining these drugs online and through social media.

Anabolic steroids have other side effects besides the development of breasts such as; painful erections, a decrease in sperm count, impotence and infertility. Tamoxifen also has many unwanted side effects including; vomiting, numbness, hot flashes, leg cramps, blurred vision, thinning hair, skin rashes, cataracts, and depression.

It is not unusual for competitive body builders to request to have all of their breast tissue removed so that they can continue with steroids without the possibility of breast regrowth.

Dr. Miguel Delgado, M.D. states that some breast tissue needs to remain in order to get a natural contour to the chest. Dr. Delgado advises his body building patients to stop performance enhancing drugs and enjoy a healthy life with an attractive male chest.

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

Thursday, April 20, 2017

Male Breast Reduction and Loose Skin

Gynecomastia Surgery and Loose Skin

BodyTite is liposuction that has a duel treatment. Along with liposuction, the device also combines radio frequency energy that tightens the skin while melting fat.

Recently the TV show “The Doctors” featured an episode showing a gynecomastia patient having a BodyTite treatment for male breast reduction.

Liposuction is one of the most popular cosmetic plastic surgery procedures and has become the focus of intensive marketing. There are variations of liposuction such as; ultrasound, tumescent, and laser assisted. Each one has multiple catchy names causing confusion for patients hoping to find the best treatment.

Over 40% of Dr. Miguel Delgado, M.D.’s gynecomastia practice is for male breast reduction revision. The revision most common is for patients that had liposuction alone by another surgeon and who did not use surgical excision of the dense breast tissue.

The “Gold Standard” for gynecomastia surgery is surgical excision of the breast tissue with liposuction for fat removal and sculpting. No matter what claims are made with marketing gimmicks, there are not any effective short cuts! The most important decision a patient can make is the selection of a skilled surgeon and not the type of liposuction that is being used.

Dr. Delgado has been performing gynecomastia surgery since 1989 and has a different technique for skin tightening. Instead of radio frequency devices, he contracts the skin by applying controlled heat directly to the underlying skin, thereby avoiding surgical excision of loose skin for most cases.

Call now (415) 898-4161 for a gynecomastia consultation for any concerns you may have about male breasts.  Serving San Jose, California since 1988.

Thursday, March 30, 2017

Classification of the Degree of the Gynecomastia Condition.

Gynecomastia Grades

Upwards of 60% of men will experience the development of female type breasts at some point in their life. The most common are for adolescent boys as they go through puberty and have changing hormones. The majority of young men will find that their developed breasts or “puffy nipples” will go away on their own within 2 months to 2 years. After 2 years if their breasts have not returned to normal, they may have permanent gynecomastia that can only be corrected by surgery.

San Jose Before and After Adolescent Gynecomastia Surgery

 Before and After Adolescent Gynecomastia Surgery

 The development of breasts can be different for each patient and requires the expertise of a gynecomastia specialist to determine the best approach for surgery. The American Society of Plastic Surgeons (ASPS) has a scale to help describe the degree of severity of male breasts.

·         Grade I: Mild severity, breast tissue is felt under the areola
·         Grade II: Mild to High severity with the breast tissue and fat outside of the areola but without excess skin
·         Grade III: The same as Grade II except there is excess skin
·         Grade IV: High severity female type breasts with excess skin

For some of the more severe grades of gynecomastia, a 2 stage procedure may be required due to excess skin. Depending on the severity of the male breast determines the surgical approach. Sometimes only one breast needs correction; a gynecomastia specialist knows how to do unilateral gynecomastia surgery to obtain symmetry.

Not long ago the term “gynecomastia” was virtually unheard of.  Due to a class action suit filed against Johnson and Johnson, the term “gynecomastia” came to the forefront. Their drug “Risperdal” which is for the treatment of autism and bipolar disorders in children had the unwanted side effect of developed breasts in young men. Attorneys were advertising on television for potential victims of the drug and ended settling for one of the largest payouts in history.

Dr. Miguel Delgado, M.D. has been performing gynecomastia surgery since 1989 and states that over 40% of his gynecomastia practice are revision cases where the original surgery was done elsewhere. Get it right the first time. Do your homework! Be sure your surgeon is Board Certified in Plastic Surgery and has extensive training in male breast reduction surgery.

Call Dr. Delgado today at (415) 898-4161 for a consultation for any gynecomastia issues.  Serving San Jose and the surrounding San Francisco Bay Area since 1988.

Sunday, February 26, 2017

Weight Loss and Gynecomastia Surgery

Gynecomastia and Weight Loss

San Jose, CA. - After overweight men lose a great deal of weight, they may find they have another issue to deal with, man boobs! With the loss of a substantial amount of fat, men may find they have a lot of redundant breast skin and tissue. The only way to reduce all the skin and tissue is by surgery. It is extremely important that men find an expert gynecomastia specialist to address this complicated condition.

Severe Gynecomastia
After Stage One with Gland Removal
The approach for male breast reduction varies depending on the man’s unique situation. An evaluation by a Board Certified Plastic Surgeon who specializes in gynecomastia will determine the best procedure. Dr. Miguel Delgado, M.D. states that some men may be candidates for the 2 stage male breast reduction surgery. In the first stage, the extra skin is removed from around the areola in a doughnut shape. The incision is closed with purse string sutures, which heal nicely around the areola. Due to the change in color and texture of the areola, the incision is well hidden. The 2nd stage is a minor procedure that can be done in the office under local anesthesia.
san Jose gynecomastia
After the second stage with a peri-areola
skin removal

Not all men are candidates for the 2 stage procedure, due to the extent of their excessive skin and tissue. For men that need more extensive removal of skin and tissue, a mastectomy type incision will be required. The incision goes around the areola and laterally down to the breast crease and then horizontal to make what is known as an anchor incision or inverted T. Even though this procedure will leave visible scars, men understand the trade-offs, and most are accepting of this.


1 month after surgery
In recent years there have been many advances made for scar management. Experienced surgeons will use deep sutures to reduce tension on the skin. The use of silicone sheeting once the incision has healed has proven to be very good in avoiding the formation of keloid scars by keeping the skin hydrated. If a patient should develop keloid scars, the surgeon may use steroid injections, scar massage or laser treatments such as the Palomar Laser, which treats scars, wrinkles, and many other skin conditions with excellent results. For more difficult scars, scar revision surgery may be the answer.

Call Dr. Miguel Delgado, M.D. at (415) 898-4161 today for any gynecomastia concerns you may have.

Tuesday, January 24, 2017

Scar Management after Gynecomastia Surgery

Scar Solutions for Gynecomastia in San Jose

San Jose Gynecomastia Surgery

Before and After Gynecomastia Surgery

During the healing process, if the body produces too much collagen, thick scars known as keloids may form. This can be disturbing to many patients depending on the location of the scar.

Dr. Miguel Delgado, M.D. states that gynecomastia patients that come to him for revision surgery are particularly upset if they develop noticeable scars around the areola. They feel they have traded one problem for another and still do not feel comfortable going shirtless.

Scar tissue is benign and medically speaking does not need to be removed. However, in cases where it is causing emotional distress, there are options for removal or at least revising the scar and making it well hidden.

Dr. Delgado has been performing gynecomastia surgery and gynecomastia revision surgery since 1989 and can offer his patients options for scar removal. Depending on the severity and type of scar, Dr. Delgado can remove or reduce most scars by; surgical excision, steroid injections and now available is the Palomar Icon Fractional Laser, a non-invasive procedure that is specially designed for the treatment of various scars.

In choosing your gynecomastia surgeon, be sure the surgeon is Board Certified in Plastic Surgery and has extensive training in gynecomastia. It is imperative to follow your surgeon’s pre and postoperative instructions to get the best surgical results. For scar management, you will be advised to avoid direct sunlight on the incisions for 6 months to a year. It has been proven that sunlight can cause hypertrophic scars.

To keep unsightly scars from forming, Dr. Delgado has his patients use silicone sheeting over the incisions once they have healed. This has proven to be a very effective way of suppressing the formation of keloids.

Call today (415) 898-4161 for a consultation with Dr. Delgado if you are looking for solutions for your gynecomastia issues.

Serving the South Bay, San Mateo and San Jose since 1986.  

Monday, December 19, 2016

Incomplete Gynecomastia Surgery

“Puffy Nipples” After Male Breast Reduction Surgery

Puffy nipples in San Jose.
Before and After "Puffy Nipple" Surgery

A common complaint that Dr. Miguel Delgado, M.D. hears from gynecomastia patients are that their “puffy nipples” remains after they have had male breast reduction surgery by another surgeon. Dr. Delgado’s gynecomastia practice has reached 40% of revision cases where other surgeons have removed too much or not enough tissue and fat from the chest.

Male breast reduction surgery requires the expertise of a Board Certified Plastic Surgeon who specializes in gynecomastia. Removing the correct amount of fat and tissue from the male chest requires expert knowledge that many surgeons do not have. Many surgeons will be very conservative in the removal of breast tissue so that they can avoid creating a “crater deformity” which leaves an indentation in the chest. However, if not enough gland is removed, the remaining tissue will push the nipple areola complex outward creating “puffy nipples.”

gynecomastia crater deformity | San Jose.
Crater Deformity After Gynecomastia Surgery
After Crater Deformity Correction

       When the male patient ends up with either “puffy nipples” or a “crater deformity” the only solution will be revision surgery. Understandably having secondary surgery is very discouraging for patients. This type of corrective surgery is much more complex than the original surgery as now the surgeon must deal with formed scar tissue from the original surgery.

It is imperative that men do their research in choosing their gynecomastia surgeon, check credentials, reviews, before and after pictures, and talk to other patients. It is best to get it right the first time!

If you are contemplating gynecomastia surgery or are in need of revision surgery, call Dr. Delgado now (415) 898-4161 for a consultation and learn what options are available to you.

Monday, November 21, 2016

Regrowth of the Male Breast after Gynecomastia Surgery. Is Possible?

After Gynecomastia Surgery, Can the Breasts Grow Back? 


san jose gynecomastia

Before and After Gynecomastia Surgery

San Jose, California

Dr. Miguel Delgado, M.D. states that many men ask him at the time of their gynecomastia consultation if it is possible for their male breasts to grow back after surgery. The answer is that in most cases the breasts will not grow back; however, there are instances where it could happen.

Dr. Delgado will try to determine the cause of a man’s breast growth through a series of questions, and sometimes testing by an endocrinologist. If it is possible to determine what made the breasts grow then action can be taken to avoid recurrence. The cause of most gynecomastia, however, remains unknown; this is referred to as idiopathic gynecomastia.

During male breast reduction surgery, most of the breast tissue and fat will be removed, but some will remain to sculpt the chest and give support to the areola. It is this remaining tissue that could be an issue in regrowth. For example, studies show that up to 65% of adolescent boys will develop some degree of gynecomastia during puberty. If left alone, all but about 5% of the adolescent cases will resolve on their own with no intervention. Cases that have breast gland remaining are referred to as persistent pubertal gynecomastia, for these young men surgery will be the only option for removal.

It should be noted that young men do very well with male breast reduction surgery as their skin is usually very elastic, pliable and contracts well back to the muscle after the breast gland is removed.

Some adolescent boys are so traumatized by breast growth that is damaging to their self-esteem. With careful consultation with the boy and his parents and possibly an endocrinologist, early surgery (as young as 12 to 14 years of age) may be warranted. However, there is some possibility of continued growth of the breasts after surgery, due to the hormones still fluctuating. Recurrence for adolescents is rare, and Dr. Delgado has never had to re-operate.

Other possible reasons for recurrence would be:
·         Continued use of marijuana or other recreational drugs
·         Weight gain
·         Some prescription drugs
·         Anabolic steroids (popular with body builders)
·         Decrease in production of testosterone (usually in older men)
·         Imbalance of levels of estrogen and testosterone
·         Psychological stress
·         Scar tissue build-up (rare but possible)

It is stressed that regrowth is rare, of the thousands of gynecomastia cases Dr. Delgado has performed over the years; he has only seen a handful of recurrent cases.

If you have concerns or fears about gynecomastia surgery, set your mind at ease with a consultation with Dr. Delgado. Call today (415) 898-4161. Serving San Jose and Palo Alto