Posted on: December 30th, 2013
By: Miguel A. Delgado Jr., MD
This 31-year-old San Francisco, CA man is 5’3” and 150lbs, having dealt with gynecomastia since adolescence. His father had the condition as well. He underwent glandular excision and suction-assisted lipectomy of the chest at Marin Cosmetic Surgery Center. His goal was to achieve “a better shape.”
San Francisco, California-It is interesting to note that all Board Certified Plastic Surgeons receive special training in the correct way to photograph patients before and after surgery. It is an exceptional tool for surgeons to accurately document their surgical planning. In addition, before and after pictures can play a vital part in helping a patient choose their surgeon.
Pictures show the patient what the surgeon’s aesthetic values are. The patient can see how organized and attentive to detail the surgeon is. If you do not see consistency and care in photographs, how do you know great attention to detail will be done in surgery?
For patients looking at a surgeon’s before and after surgery pictures of men with gynecomastia, there are a number of things to look for in determining the accuracy. Men should look for pictures of a man with a similar build and similar man boobs or moobs. Remember there are no two patients alike, so you will not find someone who looks just like you, but you should be able to get a good idea of the results you can expect. It is important to note that all of the photographs shown in Dr. Delgado’s photo albumsand displayed on his website have written consents from his patients. It is greatly appreciated that many patients are willing to share their pictures for other men to see what possible results they can expect. Sharing of pictures is by no means a requirement; all patients have the option to keep them private.
Hopefully the surgeon will show you different angles of each patient as looking at just one view may not give the true results, almost anything can be made to look good if it is from only one angle. The pictures need to be set up so that the background is consistent, such as a black drape. In addition, the positioning of the patient in the frame needs to be as close as possible for both the before and after picture. The lighting and color saturation need to be as close as possible for each picture. Body position should be identical with the arms down at the sides. If arms are raised even partially in one picture and not the other, it will change the look of the male chest, making it impossible to assess the surgical result.
Finding the right gynecomastia specialist can be very challenging for men. Some men have heard stories of plastic surgeons on gynecomastia.org that tried to remove their male breasts by liposuction alone, necessitating a secondary surgery. The only time that liposuction alone will reduce the male chest is for the man that has “pseudo-gynecomastia”, which means their gynecomastia is caused by fat only and not additional breast tissue as is the case for the man with true gynecomastia.
Now available to Dr. Delgado’s patients with “pseudo-gynecomastia” is an alternative to liposuction, CoolSculpting. CoolSculpting is a non-invasive procedure that will reduce the fat in the chest over a period of 2 to 4 months. This procedure reduces the cost of gynecomastia treatment.
For the man searching for the best top plastic cosmetic surgeon trained in gynecomastia surgery, viewing the before and after pictures of the surgeon’s patients will be extremely valuable in determining the surgeon’s skills. In addition, be sure to ask lots of questions such as; how many male breast reductions surgeries are done each year? How does the surgeon plan to do your procedure? Where will your surgery be done? If the surgeon has his or her own surgical suite, ask for a tour and note if it is organized and clean. Do you feel comfortable with the staff? Make sure the surgeon is Board Certified in Plastic Surgery and the surgical center is accredited. Call for a consultation today at (415) 898-4161 or email.
Posted on: November 30th, 2013
By: Miguel A. Delgado Jr., MD
San Francisco, CA-Pseudo-gynecomastia is man boobs that are caused by fat alone. True gynecomastia is a combination of fat and breast tissue. As discussed in previous blogs, true gynecomastia must be treated by a combination of surgical excision of the breast tissue with liposuction of the fat. Many surgeons try unsuccessfully to remove true gynecomastia with liposuction alone causing revision surgery for many men; in fact, Dr. Delgado’s gynecomastia surgery is now up to 40% redo surgeries of this type. It is, therefore, highly recommended that men seek out the best top plastic cosmetic surgeon that specializes in gynecomastia to avoid needing a “redo” of their surgery. Revision gynecomastia surgery is more difficult because now there is scar tissue from the original surgery and in most cases the skin will have lost some of its elasticity.
For the man with pseudo-gynecomastia, liposuction can give great results and is a much less invasive procedure than surgical excision.
Now, Dr. Delgado has an even less invasive procedure than liposuction for pseudo-gynecomastia, in fact, it is a non-surgical procedure that does not involve needles, scalpels, scars or even any downtime!
Available now at Dr. Delgado’s “Non-Surgical Center of Excellence” is CoolSculpting, where other non-invasive treatments such as Ultherapy, PhotoFacial and more are offered.
CoolSculpting is a process where an applicator sucks an area of fat between two cooling panels and applies intense coldness. The fat cells are destroyed by the coldness without harming the surrounding muscles and tissue and then the dead fat cells are eliminated from the body naturally. The entire process lasts about an hour and many patients read a book, work on laptops or take a nap. Patients state that the treatment is not painful, but initially they feel pressure and coldness from the plates. The results are not evident immediately as the shedding of the fat cells is a process that takes time. The results from the treatment are first evident after 2 to 3 weeks, with continuing results for up to 2 to 4 months, at which time a secondary treatment can be done if desired.
CoolSculpting is an excellent treatment for smaller areas of fat that normally are hard to target with diet and exercise. Men with pseudo-gynecomastia may be excellent candidates for fat reducing of their moobs. Other areas that are popular are the love handles, and abdomen.
There are very few risks involved with CoolSculpting; redness, some bruising and temporary numbness, are noted with most patients returning to all activities shortly after the procedure.
It is important to note that CoolSculpting can be repeated to obtain the desired outcome, but it is not meant to treat large areas of fat. Liposuction remains a more effective procedure for the patient with larger amounts of fat to be removed.
Miguel Delgado, M.D.
San Francisco, CA
For the man with pseudo-gynecomastia, CoolSculpting is an exciting possibility for an alternative treatment to liposuction. It is important to remember, most men have true gynecomastia, which means surgical excision will be needed for the removal of breast tissue for the best result. Sometimes it can be difficult to determine how much breast tissue versus fat is on the male chest. It is recommended that the gynecomastia patient schedule a consultation with Dr. Delgado to determine the best course of treatment for ultimate results and to determine the gynecomastia costs. It is possible for the male breast reduction patient to schedule a combination of procedures to save time and expenses. Call Today 415-898-4161 or email.
Posted on: October 21st, 2013
By: Miguel A. Delgado Jr., MD
San Francisco, CA-Gynecomastia.org is known as the world’s best resource for information about gynecomastia, also known as male breast reduction, moobs, man boobs, etc. Before the inception of gynecomastia.org in 1998, there was very little information available on the subject, and men suffered in silence, not aware of the prevalence of the condition.
With the advent of gynecomastia.org and other media outlets, gynecomastia is becoming recognized as a condition affecting about 60% of men at some point in their life. It has become a topic of the more you know, the more you want to know, for example watch for next month’s blog here on “CoolSculpting for Pseudo-Gynecomastia”.
In addition to the forums where men and young men can share stories and get support, the site offers a directory to help men find a gynecomastia specialist in their area. In addition to all these features, there is a huge photo gallery showing many before and after pictures of the member surgeons, including videos of patient’s experiences and results. There is a section on scientific articles covering topics from the history of the procedure, pathology, indications, treatment, etc.
Lastly, there is a blog section where the member surgeons can post on a variety of relevant topics, most recently a blog by Dr. Delgado. The recent post is on “Minimally Invasive Male Breast Reduction”. This is one of Dr. Delgado’s favorite topics that he refers to as the “light pull-through procedure”. This procedure has been around for a long time but has been greatly improved upon in recent years.
The blog explains that not all men are candidates for this procedure; it is for the man with puffy nipples and/or a small breast mound, no more than the equivalent of an A or B cup. There is a short 1 minute video showing some of the procedure, where tissue is being removed through a small incision after fat has been removed by liposuction. There are many advantages of this lesser invasive procedure including; no need for post-operative drains, a shorter amount of time in surgery, a faster recovery and with a smaller incision comes a smaller scar that heals to almost undetectable at the edge of the areolar.
Light Pull-Through Procedure on San Francisco, CA patient
To determine if you might be a candidate for this minimally invasive procedure or CoolSculpting, call for a consultation with Dr. Delgado at his 450 Sutter Street, San Francisco office or his 165 Rowland Way, Novato office in Marin County, at 415 898-4161.
In examining gynecomastia.org, be sure to check back from time to time for updates on the blog page and additions to the articles page for current information on gynecomastia. The most popular feature, however, is the forums. At any given time, there may be over 100 members’ or guests online, sharing stories, asking questions and giving first hand recommendations based on personal experience of such topics as; the best top plastic cosmetic gynecomastia surgeons, cost of male breast reduction treatment, social issues, opinions of over the counter treatments, etc. In order to participate, you do need to become a member, which helps preserve the privacy of all those who join. There is no cost to the members but there is a membership fee paid by the supporting surgeons which helps offset the cost of the maintenance of the website. The supporting surgeons are all Board Certified in Plastic surgery with a special interest in gynecomastia, with many participating in answering questions presented by the forum members.
Posted on: September 25th, 2013
By: Miguel A. Delgado Jr., MD
San Francisco, CA-It is hoped that young boys or men that have developed male breasts also known as gynecomastia, man boobs, and moobs will find this blog to help them understand what is happening.
Up to 65% of males will have detectable breast development by the age of 14, most likely caused by an imbalance of sex hormones. This is a normal condition brought on by puberty when the body starts to go through changes. You are not turning into a girl, you do not have cancer, you are normal!
Do you try to hide your chest with loose fitting shirts? Do you try to avoid taking your shirt off for gym? Do you avoid swimming? Are you embarrassed to let your parents know? You are not alone, there are many young men quietly suffering the same way you are.
Bullying has become prevalent in schools these days, and boys that have developed breasts are a great target for cruel nicknames that can cause self-hatred and isolation. It is important to understand that gynecomastia or the male breast is a benign (harmless) condition even though it is socially lethal!
The good news is that for most boys, 90% to 95% the condition will go away by itself without any type of treatment, within a few weeks to 2 years. But two years for a young man can feel like eternity, what can you do in the meantime? Getting emotional support from your family or other sources can be a great benefit.
First, check out a website called gynecomastia.org, there you will find many guys that are sharing stories of how they have suffered and what they have done about it. This is a website dedicated to getting out information on gynecomastia and support from other members through the discussion boards. You do need to sign up and become a member to have access to all the site has to offer, but there is no charge. Review the stories that have been posted such as this one “A Mother’s Story”. Notice at the end of this story that the Mother recommends that you tell your parents, as difficult as this may be; they probably have no idea that you are suffering and most parents will do whatever it takes to spare their sons this type of humiliation. Try to talk to your parents, they may be much more understanding than you realize.
If the idea of talking to your parents is just impossible for you, try composing an email telling them how miserable you have been with a link to the above letter, and a link to gynecomastia.org. There are many stories posted of parents who discover their child has been suffering, and they were completely unaware! For example, another story tells of a boy who finally went to his father and asked if the money that had been saved for him for college could be used instead for male breast reduction surgery. The father was beyond shocked to find out his son had been dealing with a situation he knew nothing about, and he had never even heard of the term gynecomastia before. The father was able to get a line of credit to cover the cost of gynecomastia treatment, and his son was still able to go to college. The surgery proved to be a life changing event for his son.
This is an 18 year old male who presents with adolescent gynecomastia. He complained about having “fluffy nipples”. His goal was to flatten the nipples to look more natural in his clothing. He had suction assisted liposuction with glandular excision. His post surgical recovery displays his newly flattened nipples.
As mentioned earlier, most boys will find the male breasts will go away on their own within a few weeks to a couple of years. If they do not, there are different surgical treatments available depending on the severity of the case.
Unless you have “pseudo-gynecomastia”, be wary of a surgeon that claims liposuction alone will give you the result you want. True gynecomastia consists of breast tissue and fat, liposuction will only get rid of fat, breast tissue is much denser and needs to be removed by surgical excision. Whereas pseudo-gynecomastia is caused by fat alone and can get great results with liposuction or weight loss.
In searching for information on the internet be careful about ads that claim you can take a pill to get rid of moobs. Save your money they do not work as attested to by many men on gynecomastia.org.
It would be wise to see a top cosmetic Board Certified Plastic Surgeon who specializes in gynecomastia surgery with your parents, to find out what your options are, and how likely the male breasts will go away on their own. Dr. Delgado stays abreast of all new innovations in plastic surgery such as “CoolSculpting” for fat removal which is now available at the “Non-Surgical Center of Excellence” at his Marin County location.
Posted on: September 2nd, 2013
By: Miguel A. Delgado Jr., MD
San Francisco, CA-Men who have quietly suffered for years with female type breasts, known as gynecomastia, are surprised to discover how many men have the same condition also known as moobs and man boobs. Information now readily available on the internet educates men about gynecomastia that only a few years ago were unknown, they are able to research and find the best top plastic cosmetic surgeons. In addition to the internet, there has been a lot of exposure through other media outlets such as television, radio and magazine articles that have led to further investigation on gathering information on costs of gynecomastia surgery and male breast reduction treatment.
What a relief it has been for men to find that it is a common condition, and there are options available that until recently were unheard of. Looking through the search engines, one site comes up repeatedly as the “web’s best resource for information about gynecomastia”, www.gynecomastia.org.
This website was started in 1998 by psychologist Merle Yost, who counseled many men with gynecomastia. He had great empathy for his patients as he was a sufferer of the condition himself. Understanding how important it was for men to have support, the site offered many different forums for men to reach out to each other, share stories, pictures and ask questions. As the popularity of the site grew different needs became evident. A section was added where questions could be asked directly to gynecomastia surgeons who monitor the site.
Gynecomastia is not confined to the United States; men all over the world are plagued with the condition. In order for men to get support in their own country and even correspond in their own language, there is a section on gynecomastia.org “Local forums/find a Surgeon in your area”.
The first country represented is the United Kingdom (UK), it appears that one of the main issues is trying to get their government insurance to cover the surgery which entails waiting several months to even more than a year to see a psychologist who then needs to recommend the patient for surgery. Of those who have experienced this, they report that they cannot choose their surgeon and some are more experienced than others, making it quite risky. According to the posts, it is recommended that guys from the UK save their money and have the surgery done privately. What a great advantage for a man to get this information from men who have already experienced it, instead of finding out by trial and error.
The next country is Canada; again a big concern there is trying to get coverage from their government insurance for male breast surgery. They also discuss the difference between local and general anesthesia, and post-operative scars.
In Asia, men are asking about the comparison of liposuction versus liposuction and excision. It is encouraging to see that contributors to the forum have learned that for the majority of all male breast reduction cases that liposuction alone will leave the patient very dissatisfied and they advise all readers of this. Also, Asian men discuss issues with the compression garment and trying to hide their man boobs from friends.
From the land “down under”, Australia/New Zealand; there are discussions about; what is the best time of year to have surgery, experiences with drains and changes the patient will deal with in adjusting to a new “body image”.
Europeans seem to be gravitating to Poland for surgery; there are many posts about this. In addition, they discuss the benefit of seeing before and after pictures of a surgeon’s own patients and wisely ask why some will not show photos.
South America/Latin America/Spain/Africa and the Middle East have their own forum with stories to share.
Sweden has an active site where members can converse in their own language.
The common thread with all the forums from the different countries is finding the right surgeon and hopefully one close to home or easy to travel to in a major city. In addition to asking about specific surgeons, men want to know how they do the procedure, where it will be done, the cost and the surgical results. It is most encouraging to see how men educate each other by sharing their personal experiences.
Posted on: July 31st, 2013
By: Miguel A. Delgado Jr., MD
Miguel A. Delgado, Jr., M.D.
San Francisco, CA-Most patients are nervous when they have an appointment to see the doctor. This is especially true for patients seeking elective procedures as they have additional concerns about vanity and may feel guilty for indulging in something that is not necessary but will make them feel better about themselves.
It is the exceptional office that has a staff that understands the feelings of the new patient and has the ability to make them comfortable from the moment they arrive for their first consultation visit.
When arriving for a gynecomastia initial consultation, the patient will be escorted to an exam room and will be joined by Dr. Delgado. Dr. Delgado’s warm and friendly manner puts patients immediately at ease. Many patients have made the comment that they do not feel that Dr. Delgado talks down to them as many doctors are known to do, but more on an equal basis that builds trust and allows the patient to feel comfortable asking any questions that they may have.
To begin the consultation, Dr. Delgado has several questions he will ask. Usually he will want to know how long the patient has had male breasts, and when did they develop. He will want to know if there has been any noticeable change with weight gain or loss. Does he take his shirt off in public? Do other men in the family have gynecomastia? And what are his goals?
At this point, Dr. Delgado explains his surgical technique of excision combined with liposuction, pointing out that liposuction alone is only for the patient that has what is known as “pseudo-gynecomastia”, meaning fat alone is causing the male breasts. He points out that 40% of his gynecomastia cases are now revision surgeries, due to the original surgeon using liposuction alone and leaving breast tissue behind.
He goes into great detail to explain how the incisions are placed around the areola so that after healing they are almost invisible.
Drains are placed at the end of surgery Dr. Delgado explains, in order to remove fluid that normally collects when there is a “dead space” left after removal of fat and tissue. He shows how a compression vest will be worn to assist in the healing of the chest, and that he has them custom made to include pockets for the drains. Further, he says that the vest will be worn for 6 weeks and after that all normal activities including exercise can be resumed.
Now Dr. Delgado will do an exam of the patient’s chest and will be able to give a personalized evaluation of what he recommends. After the examination, the patient then will meet with Dr. Delgado in the office of the patient care coordinator. Dr. Delgado has several albums of before and after pictures of his male breast reduction patients that he presents. He will show where the incisions are and how they healed; he shows the small scar from the drain and how he now has it hidden in the armpit. These photographs will give the patient a good idea of Dr. Delgado’s work, and the results that can be anticipated.
Many patients choose to have additional surgery done at the same time to save money and recovery time. For patients that are interested, Dr. Delgado will show pictures of patients that have had a combination of surgeries. Popular add on surgery, for example, would be, liposuction of the love handles and/or abdomen, some may want facial surgery such as a rhinoplasty (nose job) or eyelid surgery or possibly a chin implant. Dr. Delgado will be happy to discuss additional surgery at the initial consultation if requested.
At the end of the consultation with Dr. Delgado, the patient then meets with the patient coordinator who will present the fees outlining gynecomastia costs and answer any additional questions the patient may have such as pre-operative and post-operative instructions, financing, and scheduling surgery. The patient is encouraged to call the office at any time with additional questions for the patient coordinator or Dr. Delgado.
In his quest to educate his patients and make them as comfortable as possible prior to the consultation, Dr. Delgado produced a 6 part video that is posted on his website and You Tube showing the whole process from the initial consultation to post-operative visits and the patients final impressions.
Posted on: July 15th, 2013
By: Miguel A. Delgado Jr., MD
This 26-year-old San Francisco patient is 5’6” and 172lbs. He underwent glandular excision and suction-assisted lipectomy of the chest and axillae. From the axillae, I removed 400cc of fat from the left and 450cc from the right. From his chest, I extracted a total of 250cc of fat from the right and 202cc from the left. I also excised 35 grams of glandular tissue from the right side of his chest and 29 grams from the left side.
San Francisco, CA-What is gynecomastia? Gynecomastia, also known as moobs, man breasts, and man boobs are the description of the development of male breasts, it will affect 60% or more of all men at some point in their lifetime.
The question of possible non-surgical options for getting rid of gynecomastia comes up frequently for all gynecomastia surgeons from adolescents and men hoping to find a resolution to get rid of the male breasts without cosmetic surgery.
The cause for some types of gynecomastia needs to be ruled out before attempting surgery or non-surgical methods. For example, 90% of adolescents will find their gynecomastia will go away on its own after puberty with no treatment at all. If a patient is suffering from “pseudo-gynecomastia” which is caused by fat alone, weight loss or liposuction may get rid of the man boobs, but liposuction is a surgical procedure. Some men will find that losing weight or removal by liposuction will leave them with loose skin, and then may opt for surgical skin tightening.
For all others, it is important to try to determine the cause of the development of male breasts so that it will not reoccur if surgical intervention is the choice. For example, many men develop breasts while taking certain prescriptions drugs, or steroids, or smoke marijuana or other illicit drugs. Consulting with a gynecomastia specialist is recommended to help determine the cause and to stop the offending drug or find an alternative.
There are men suffering with moobs that do not have surgery as an option. There are some measures that can be taken, but unfortunately, none will actually get rid of their gynecomastia.
One option that some men choose is to wear a gynecomastia compression type shirt; there are many styles and manufacturers to choose from and can usually be worn undetected under clothing. However, the compression vests can be binding and/or hot, and a trip to the beach or swimming or any activity that involves removing ones shirt, still presents a problem.
Exercise and lifting weights can build pectoralis muscles and will enhance definition, but the male breasts will remain, and the additional muscle mass may make them even more noticeable.
If any research is done on the internet about gynecomastia, it is almost impossible not to see advertisements for herbal based supplements that allege they can reduce fat cells in size and quantity. The main ingredient is Chromium Picolinate, which is found in many over the counter diet products, and their fat reducing claims remain unsubstantiated. Even if they did work, they are only claiming a reduction of fat and not breast tissue which is present in all cases of true gynecomastia. There have been many reports on www.gynecomastia.org from men who have tried these products and they report very disappointing results. If you are tempted to try these products, before plunking down money, check Google reviews for the product, make sure that they are not posted by the company themselves as they have multiple websites and they do a very high volume of advertising.
The Mayo Clinic recommends that men who do not have surgery as an option seek psychological counseling and/or find support groups with other men suffering with gynecomastia, such as www.gynecomastia.org. There is comfort to be gained by learning how others deal with their condition, and many stories are shared on this popular site. For some men learning to live with gynecomastia without self-loathing is definitely an option.
Men who are able to have male breast reduction surgery and choose this option have an extremely high patient satisfaction rate. For several years in a row male breast reduction surgery has been on the increase, The American Society of Plastic Surgeons (ASPS) reports that for 2012, there was an increase of 5% over 2011.
Posted on: July 1st, 2013
By: Miguel A. Delgado Jr., MD
This is a 17-year-old resident San Francisco Bay Area, California who presents with gynecomastia. He underwent gland excision and suction assisted lipectomy with 150 cc of fat aspirated from each side.He had 46 grams of tissue removed from his right chest and 400 grams of tissue removed from his left. His postoperative photographs are taken 3 months after surgery.
San Francisco, CA-Gynecomastia, often misspelled, mispronounced, and misunderstood. Most people are not aware that having male breasts is a condition that can be caused by many different factors including, heredity, prescription drugs, illegal drugs, steroids, Klinefelter’s syndrome, puberty, aging, weight gain, and cancer of the male breast. For some, the cause remains unknown. If a pediatrician tells parents that their son has gynecomastia, many ask “what is gynecomastia?”If parents haven’t heard of the condition, how can they help their sons?
In 1995, there was an episode on Seinfeld where Kramer one of the main characters, invented “the Bro” also to be known as “the Manssiere”, a bra for men. This episode brought humorous attention to the condition except for those that suffer with male breasts. Negative attention has been in the media off and on ever since with cruel descriptive words like; man boobs, moobs, bitch tits, he-hooters, dude rack, man cans and more.
As boys enter puberty, it is not uncommon for them to develop female type breasts or what is termed as “puffy nipples”. At an average age of 13, this phenomenon is usually brought about by hormones being out of balance, but usually when the hormones even out the breasts will disappear. When the hormones are raging, for both boys and girls, they can become extremely emotional and sensitive and for good reason, their bodies are going through a lot of changes. This can be a very confusing time for young people and having supportive parents can make all the difference in the world.
As much as 40% to 50% or more young men going through puberty will develop some degree of gynecomastia on one or both sides. A visit to the pediatrician is in order to monitor any breast growth. For 90% of young men, the gynecomastia will resolve on its own within a few months to a couple of years. For the small percentage of boys that the gynecomastia remains, parents ask, “what is the treatment for gynecomastia?” There are no known treatments that can reverse the formation of breast tissue once it has remained past puberty except male breast reduction surgery. The good news is that the male breast reduction procedure is very successful with almost no evidence of surgery having been performed.
Gynecomastia can be demoralizing for any man, but for young boys who do not understand what is happening to their body, it can be devastating. Most feel it is their fault and experience incredible shame. They are not comfortable telling anyone what they are going through and do their best to hide their chest with loose fitting shirts. They avoid situations where they might have to bare their chest, such as going to a pool or the beach. It is amazing how many young boys are able to hide their breasts from their parents and hide the agony they are experiencing. Classmates can be especially cruel with teasing and name calling for the boy with breasts.
It is hopeful that parents will notice any unusual breast development in their son so that they can be good support for them. If it is before puberty starts or before 9 years of age it could be a more serious complication, and he needs to be seen by a physician. Search engines on the internet make information readily available. Family members or friends who have some knowledge of gynecomastia may take parents aside and guide them to seek help for their son. Pediatricians are in a position to alert parents and educate them and their son.
The World’s best resource for information on gynecomastia is www.gynecomastia.org. There is a directory of Board Certified Plastic Surgeons throughout the United States. The site offers many before and after pictures of male breast reduction patients, a blog page with interesting articles posted by member surgeons.
The most popular and active section of the site is the forums. One of the most popular forums is called “gynecomastia talk” where boys and men can share questions and experiences, and then there is a forum called “your stories”, one called “ask a doctor” whereby guys can post questions to the surgeons who are members of the site.
Another forum is called “surgery success stories”, this section has several stories written by boys and/or their parents. One in particular tells of a boy who had been silently suffering with his gynecomastia breasts for a long time and finally in an attempt to hide them better ordered a compression shirt that was supposed to help flatten his chest. His package arrived when he wasn’t home, and his Mom saw it first. When he came home and saw her with it he was beyond embarrassed, but it turns out his parents were very supportive and even willing to down-size their house in order to have enough money for him to have male breast reduction surgery. He didn’t allow that to happen, but the door was now open for them to have good communication and find a way to resolve his problem. This incident helped him to have a closer relationship with his parents.
There are many similar stories posted on gynecomastia.org. Unfortunately, not all young men are so lucky to have such supportive parents, but many of the forum members encourage young men to try talking to their parents. For those that do not have a good support system, gynecomastia.org is even more valuable. Many boys and men have found the support they need from other forum members, with ways to deal with all the different issues gynecomastia presents.
Posted on: June 18th, 2013
By: Miguel A. Delgado Jr., MD
Paulus of Aegina
Physician and Surgeon
San Francisco, CA-Men suffering with moobs, or male breasts have asked “What is the history of gynecomastia?” First introduced in the second century A.D., the term “gynecomastia” means; woman “gyne” and breasts “mastos”.
The first known record of a physician to address the issue of male breasts was Claudius Galenus also known as Galen, a famous physician and philosopher of that time. Galen was a physician to five Roman emperors. He produced over 500 books on medical science and philosophical subjects. He became a very famous physician and had his own pharmacy stocked with medicines he made from extracts of vegetables and animals.
Galen’s influence remains today; the word “galenic” describes medicines and drugs from animals and vegetable ingredients. While he was the physician to the emperors of Rome, he treated wounded gladiators giving him a wonderful opportunity to study the anatomy of man and perform surgery. It is not recorded that he actually attempted male breast reduction surgery, but he has the earliest record of describing the condition as an abnormal amount of fat in the male breast. History does not report any attempts at surgical correction of gynecomastia until five centuries later.
During the later years of the Roman Empire, it is believed that the seventh century Byzantine physician Paulus of Aegina (625-690AD) was the first to attempt a surgical treatment of gynecomastia, believing it to be caused by the formation of fat and advocating excision through a single sub mammary lunar incision or in more severe cases through two lunar incisions extending well beyond the areola. This procedure had been used extensively, but the resulting scars were broad and conspicuous causing almost as much embarrassment as the original condition itself. Paulus is best known for writing a collection of books known as “Medical Compendium in Seven Books”, containing the sum of all Western medical knowledge. It was unrivaled in its accuracy and completeness. As a competent and skilled surgeon, the sixth book was devoted mainly to surgery, and he may be known as one of the originators of plastic surgery as we know it today. In the book, he describes the different surgical processes and techniques including his personal experiences and observations. He conveyed plastic surgery experience and knowledge for such procedures as, nasal and jaw fractures, and gynecomastia, etc. that has been passed down through the ages. He was the first to describe physical characteristic that are still significant today such as the prevalence of gynecomastia in the adolescent, and the presence of fat deposits in many but not all patients, and that some patients will need secondary surgery.
Advances in the procedure continued through the eighteenth and nineteenth centuries, but the most notable progress was by Jerome P. Webster, M.D. There was an article published in the Annals of Surgery by Dr. Webster in September 1946 called “Mastectomy for Gynecomastia Through a Semicircular Intra-Areolar Incision” whereby he describes an operation he devised with a semicircular intra-areolar incision and he first performed it in 1934. It was done under general anesthesia by two surgical teams, one on each side, in order to keep the surgical time as short as possible, and then hope the surgeons had a similar technique. Webster’s procedure made the greatest impact on gynecomastia surgical treatment.
With the exceptional advances in surgical technique and anesthesia that we have today, men have more surgical options that include minimally invasive procedures, for outstanding results with little or no visible evidence of surgery performed.
Posted on: May 31st, 2013
By: Miguel A. Delgado Jr., MD
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.
After Surgery for Crater Deformity Correction