It's Time

2017 03-05

Gynecomastia | Male Breast Reduction After Weight Loss

Gynecomastia Surgery After Losing Weight


Gynecomastia is a very sensitive issue for men to deal with, especially if they have lost a lot of weight but still have “man boobs.” Men who have lost weight and are seeking male breast reduction surgery will find that the traditional procedure will not remove enough skin and tissue. Alternative measures will need to be taken. It is imperative for men to be sure that their Board Certified Plastic Surgeon has extensive training in gynecomastia for this complicated condition.


Depending on the individual’s situation, some men may be candidates for what is known as the 2 stage procedure. For this surgery, the surgeon will excise redundant skin, tissue, and fat in a doughnut shape from around the areola and close the incision with purse-string sutures.  Once healed, stage 2 which removes the breast crease, can be done as an office procedure under local anesthetic.

Severe gynecomastia
Six months after stage one
Two weeks after second stage

If the 2 stage procedure is not an option, it may be necessary to go with a mastectomy type incision that goes around the areola, vertically to the breast crease making what is known as the anchor or inverted T incision. This incision is not hidden but usually heals well, and the patient understands that in order to reduce the male chest.

Gynecomastia after weight loss - San Jose, CA
Gynecomastia after weight loss


Gynecomastia after weight loss
Double incision tissue removal and free nipple graft.


Fortunately today there are very good scar treatments, Dr. Miguel Delgado, M.D. uses silicone sheeting over the incisions once they have healed, this will keep them hydrated. For incisions that may heal and form a keloid, or raised scar, there are steroid injections, and massaging the scar can also prove helpful.  Additionally, there is laser treatment such as the Palomar Laser that Dr. Delgado has available for his patients. The laser not only treats scars but wrinkles and various other skin conditions. And finally, scars can be minimized by scar revision surgery.


Call now (415) 898-4161 for a consultation with Dr. Delgado to discuss any gynecomastia issues you may be having.



2017 02-03

Improving Scars after Gynecomastia Surgery

  Gynecomastia Scar Treatment | San Jose

 Before and After Gyne Surgerysan jose
Before and After Gynecomastia Surgery with scar treatment


San Jose, California – In most cases, the incision for gynecomastia that goes partially around the areola, will heal and be almost undetected. Due to the change in skin texture and color of the areola, the scar is well hidden after it heals. However, for some unknown reason, some people produce more collagen than others when recovering from surgery. Raised scars are referred to as keloids or hypertrophic scars. Excess collagen in scar formation can be unsightly, and the gynecomastia patient will have traded one problem for another.


Dr. Miguel Delgado, M.D., a Board Certified Plastic Surgeon who has specialized in gynecomastia since 1989, states that it is not medically necessary to remove male breast reduction scars, but it can cause a lot of embarrassment for the gynecomastia patient who wants the ability to go shirtless.


Today, there are options for minimizing scars. Depending on the severity and type of scar, surgical excision may be the best choice or steroid injections. Another very effective treatment that is now available at Dr. Delgado’s Marin Cosmetic Surgery Center is the Palomar Icon Fractional Laser, a non-invasive laser procedure that was created for scar treatment, wrinkle reduction, sun damaged skin and various other skin problems.


Dr. Delgado stresses the importance for men to follow all of their surgeon’s postoperative instructions, and states that those who do have the best results. The directions include avoidance of direct sunlight on the incisions while they are healing, for at least 6 months to a full year. Dr. Delgado advises his patients to keep their chest covered and use sunblock whenever outdoors during this period of healing. Sunlight is known to exacerbate the formation of hypertrophic scars.


Once the incisions have healed, Dr. Delgado has his patient’s start using silicone sheeting. Silicone will help control the formation of keloids.

If you have any gynecomastia revision issues, call (415) 898-4161 today for an appointment with Dr. Delgado.  Serving San Jose, San Mateo and the South Bay since 1986

2016 12-22

Incomplete Gynecomastia Surgery-Why?

After Gynecomastia Surgery Puffy Nipples Remain


             Puffy Nipples                                   After Corrective Surgery

It is not uncommon for a man to have gynecomastia surgery and then end up with “puffy nipples.” In the hands of less experienced surgeons who perform male breast reduction, all too often they will leave too much breast tissue behind. The remaining tissue behind the areola complex will push the nipple out and may be even more pronounced than before surgery.

Surgeons who attempt male breast reduction by liposuction alone will find that only the fat has been removed. The breast gland is too dense to be removed by the cannula. Only when a patient has pseudogynecomastia (enlarged breast due to fat only) will liposuction be a good technique.

In another scenario, some surgeons use liposuction and surgical excision of the gland, but so they don’t create what is known as “crater deformity” they are very conservative in the amount that is removed. Not removing enough of the breast gland will also result in “puffy nipples.”


          Crater Deformity                                                                        After Corrective Surgery

Dr. Miguel Delgado, M.D. has been performing gynecomastia surgery since 1989 and he states that 40% of his gynecomastia practice is revision surgeries to correct both “puffy nipples” and “crater deformity” for men that have had their surgery from another surgeon.

When choosing your gynecomastia surgeon, do your homework! Check that your surgeon is Board Certified in Plastic Surgery and has extensive training in gynecomastia surgery. Ask to see many before and after pictures of patients, and read reviews.

If you are considering male breast reduction surgery, or if you are in need of gynecomastia revision, call today (415) 898-4161 for an appointment with gynecomastia expert,

Dr. Miguel Delgado, M.D.

2016 11-26

Gynecomastia Surgery and Recurrents

Can Male Breasts Recur After Gynecomastia Surgery?


Before and After Gynecomastia Surgery


San Jose, California

Men who opt for male breast reduction surgery frequently ask Dr. Miguel Delgado, M.D. if it is possible for their breasts to grow back. It is possible for recurrence, however, it is rare. For true gynecomastia, the surgeon removes most of the breast gland and fat that are responsible for the enlarged male breast. Some tissue and fat remain to shape the chest and give support to the areola. It is the remaining tissue and fat that could pose a problem in the future.


Adolescent gynecomastia affects 65% of all young men. The good news is that for all but about 5% will find that their chest returns to normal within a few months up to 2 years. For the remaining young men, unfortunately, the male breast is permanent, and surgery will be their only option for a normal looking chest. Some young boys are so traumatized by having male breasts that surgery before finishing puberty may be recommended.


It is preferred to wait until a young man has completed puberty before having gynecomastia surgery; however, some boys have severe psychological issues and may be a candidate for early surgery. Since they have not completed puberty, and their hormones are still fluctuating, it is possible for the remaining tissue to regrow. Although Dr. Delgado says, this is very rare and for all the cases of young men that he has performed, he has never had to re-operate.


Another factor causing the reappearance of the male breast would be for a man who has gained a lot of weight. Even though many of the fat cells have been removed, the ones remaining will get larger with the additional storage of fat.


At the time of the consultation, Dr. Delgado will try to determine what caused the growth of the male breast so that steps can be taken to avoid recurrence in the future. Some of the more known possibilities responsible for gynecomastia after puberty and weight gain are:

  • Some prescription drugs
  • Testosterone and estrogen levels out of balance
  • Marijuana and other recreational drugs
  • Lower testosterone levels (usually in older men)
  • Anabolic steroids mostly used by bodybuilders
  • Psychological stress


The cause of gynecomastia for many men remains unknown and is referred to as idiopathic gynecomastia. Dr. Delgado has performed thousands of male breast reduction surgeries and has only seen a handful of cases of recurrence.


Schedule a gynecomastia consultation now with Dr. Delgado at, (415) 898-4161 to find what options are available for you.


2016 10-28

Gynecomastia a World Wide Concern

Men Around the World Suffer From Gynecomastia



This patient had liposuction and gland excision, fat and aspirate were removed, 350cc on the right side, 400cc on the left. The surgery was performed at Marin Cosmetic Surgery Center. The after picture is 2 months after surgery.

Each year the statistics for gynecomastia surgery have increased, according to the American Society of Plastic Surgeons. Many news articles show men seeking male breast reduction surgery have gone way past the shores of the United States.

Recently, there was an article published about a man from Singapore who we will refer to as David. David had been suffering from female type breasts for over 20 years. His breasts not only embarrassed him but were causing physical pain. Concerned that his chest pain might be due to heart problems, he sought medical advice. His exam showed that he was healthy and did not have any heart issues.

David still looking for a solution thought perhaps diet and exercise might cure him. However, even though he did lose weight, he still had breasts, and his chest pain had not abated. Frustrated, he started researching online about gynecomastia. David found a gynecomastia surgeon who confirmed that he had gynecomastia. David’s wife supported his decision to go ahead with surgery, and his comments after surgery is a common one that Dr. Miguel Delgado, M.D. hears quite often, “why didn’t I do this sooner?” David stated that he finally feels like a “real man.” He shares his story with the hopes that other men won’t wait 20 years to get a resolution to their man boobs!

Another article reveals that there is a growing demand for cosmetic surgery in Scotland for both men and women. New medical clinics are popping up in major cities to meet the needs of the population. One of the most sought after procedures for men is male breast reduction, up 13% over 2014. Young men who work out in the gym want a flatter chest and men who have substantial weight loss want their loose skin tightened.

Dr. Delgado recommends that his patient’s visit where they will find a plethora of information. Also, there is a section devoted to “International Forums” specifically for men outside the country. The site offers extensive information and support from other members. In addition, there is a directory to help men locate a surgeon in their area.

Dr. Delgado, a gynecomastia specialist, has performed surgery for men from all over the world. Out of town patients receive assistance in their travel plans. Call today (415) 898-416 or email for a consultation. For men out of state or out of the country a complimentary consultation via Skype or phone is available.

2016 10-01

Gynecomastia Surgery-Getting Prepared.

Getting Ready for Gynecomastia Surgery

San Jose, California | One of the top two plastic surgery societies is the “American Society of Aesthetic Plastic Surgeons” (ASAPS). The purpose ASAPS is to sponsor scientific meetings for their 2600+ board certified members. The latest innovations in plastic surgery are presented at these meetings.

ASAPS created “Smart Beauty Guide,” an online informational website. The objective of the guide is to educate the public in all aspects of cosmetic plastic surgery and support making smart choices.

The guide offers detailed information about many cosmetic procedures, before and after pictures, and posting questions to board certified plastic surgeons. Most importantly, the guide provides a directory where patients can find board certified plastic surgeons in their area. The directory gives detailed information on the surgeon’s credentials and training.

A valuable component of the guide is the information it provides the patient in preparing for surgery. For men contemplating gynecomastia surgery, the following recommendations are listed:

  • If you smoke, stop 4 weeks before surgery as it interferes with healing.
  • Discontinue all blood thinners such as aspirin 2 weeks before surgery.
  • Sun exposure may increase scarring, avoid tanning 2 weeks before surgery.
  • Be sure to drink plenty of water and stay well hydrated.
  • Inform your surgeon if you have any infections or illness.
  • Plan enough time off work for recovery.
  • You will need a responsible adult to bring you home after surgery and stay with you for the first 24 hours.
  • Prescriptions need to be filled before surgery.
  • Have your blood test done promptly.
  • Plan things to keep you occupied during recovery such as reading material, movies, laptop, etc.
  • If you don’t have someone to prepare meals for you, have some frozen meals handy.
  • Have plenty of clean clothes that open in the front available.


Dr. Miguel Delgado, M.D. provides a comprehensive surgical handbook to his patient’s that is specific to their procedure. In addition to the above information, he has detailed instructions for reference. However, patients are encouraged to call Dr. Delgado at any time they have questions.


Start your journey today to feel comfortable going shirtless! Call (415) 898-4161 for a gynecomastia consultation. Serving San Jose,California since 1986.


2016 08-24


Suggested Questions for the Gynecomastia Consultation

gynecomastia goggle


Men notoriously have a hard time asking for help, especially when it comes to seeking cosmetic plastic surgery. However, due to the humiliation caused by enlarged breast tissue, the percentage of men seeking solutions increases each year. Taking the first step in scheduling a consultation with a gynecomastia specialist may be the hardest part. Dr. Miguel Delgado, M.D. has stated that his male breast reduction patients show a great deal of relief once they meet with him and learn that he can put an end to their suffering.

Dr. Delgado’s main goal is to put his patient’s at ease and let them know that he understands their angst. He will explain to them how gynecomastia surgery will give them their life back. It is important for men to understand exactly how male breast reduction will work for them. Dr. Delgado understands that when men first come in that they are nervous and that it may be difficult for them to express their concerns. He suggests that men write down their questions before coming in so that they won’t forget any concerns they may have.

Dr. Delgado encourages men to feel that they can call the office at any time if they have more questions or something that might not have been covered during their consultation. If you are seeing Dr. Delgado or another gynecomastia specialist, you may want to refer to the suggested questions below.


  1. Make sure that your surgeon and anesthesiologist are board certified.
  2. Where will the surgery be performed? Is it accredited?
  3. How many male breast reduction cases does your surgeon do each year? For how many years?
  4. There are different ways to do gynecomastia surgery, how will yours be done? Where will the incisions be?
  5. How long will the surgery last and how long before you can go home?
  6. What will you need at home for aftercare?
  7. What medications will be prescribed? Be sure to let your surgeon know all medications and supplements you are taking now.
  8. Ask if liposuction alone can get rid of your gynecomastia.
  9. Will you need drains and a compression vest? If so, for how long?
  10. How long before you can return to work?
  11. When can you resume going to the gym or restart your exercise program?
  12. What risks are associated with male breast reduction?
  13. How are complications handled?
  14. Can your male breasts grow back?
  15. Ask to view before and after pictures
  16. What fees are involved?


Call now (415) 898-4161 to start your journey of freedom from male breasts!

2016 08-03


The Male Breast Reduction Consultation and Physical Exam.

Knowing what to expect during the gynecomastia consultation and physical exam takes away much of the anxiety men feel when they have made the decision to see a gynecomastia specialist.

During the initial consultation, Dr. Miguel Delgado, M.D. will try to determine the cause of gynecomastia and how it affects the patient’s life. He will discuss the patient’s goals and expectations. Dr. Delgado will explain in detail the surgical procedure. In an earlier blog, Dr. Delgado describes what to expect during the consultation, which you can read in its entirety here.



A physical exam will follow in order for Dr. Delgado to make his recommendations. The intent of this blog is to explain what takes place during the physical.

First, the patient lies flat on the exam table so that Dr. Delgado can do a pinch test. By taking his forefinger and thumb, he gently squeezes the area around the areola (see picture). Dr. Delgado is checking to see if he can feel a firm disk-shaped mass and if present, this would indicate “true gynecomastia” which is both fat and breast tissue. True gynecomastia is treated by both liposuction and surgical excision. If, however, no mass is present, it is likely the patient has “pseudogynecomastia” which is fat alone. Most men have true gynecomastia but for those that have pseudogynecomastia it is possible to get good results from liposuction alone and in some cases the non-surgical treatment “CoolSculpting.”

Second, Dr. Delgado will note if there is any discharge from the nipple or any enlargement of the lymph nodes in the armpits or breasts. If there are any lumps or asymmetry of the testicles more testing may be necessary. Even though breast cancer in men is very rare, it does occur. If anything seems suspicious during surgery, tissue samples will be sent to pathology.

After the physical, Dr. Delgado will show the patient many before and after pictures and all questions will be answered.

Lastly, the patient coordinator will present the patient a fee quote and answer any questions related to scheduling surgery.

If you are ready to take the next step and schedule a consultation with Dr. Delgado, call (415) 898-4161. Serving the San Francisco South Bay, San Jose, Palo Alto and San Mateo since 1988.



2016 06-20

A Patient’s Gynecomastia story

Get This Off My Chest! Stories by Gynecomastia Patients

Google search



Dr. Miguel Delgado, M.D. recommends that men who suffer from female type breasts Google “patient’s stories about gynecomastia.” It is true that there is comfort in numbers; many men feel better when they find they are not alone with the humiliating condition known as gynecomastia. Men are very private about anything that makes them feel less masculine, and having female type breasts is probably the worst.


For men who have proceeded in having gynecomastia surgery, the relief is so tremendous that many have stepped forward to share their story in the hopes that they may help other men.


One of the published stories shares a man’s frustration in trying to lose as much weight as possible, but nothing seemed to reduce his breasts. He was determined to put an end to his suffering, so as embarrassed as he was he finally consulted with a gynecomastia specialist. That day changed his life. He was so relieved when he met the compassionate doctor and the staff he scheduled surgery. You can read his posting here. Note that he posted his before and after pictures.


In another story, a man shares how he fought anxiety and severe depression due to his female type breasts. He avoided activities that would require him to remove his shirt, such as pool parties or going to the beach, he instead sat in front of a computer all day. After suffering for nine years, he started researching gynecomastia. Ready to end his suffering, he went to see a specialist and proceeded with surgery. He is another ecstatic patient who wanted to share his story and much of the information he gathered during his research, which you can read in its entirety here.


For many more stories, visit known as the “Web’s Best Resource for Information.” In addition to multiple stories, the site offers forums where patients can ask and answer questions of each other and member gynecomastia surgeons. Other sections of the website show hundreds of before and after pictures of male breast reduction patients, videos, and a directory of gynecomastia specialists listed by state.


Gynecomastia specialist, Miguel Delgado, M.D. of the San Francisco Bay Area invites you to call today (415) 898-4161 for a consultation to learn what options are available to you. For patients out of the area or out of state, he offers a generous travel package.


2016 04-16

Gynecomastia Surgery Increases 5% Over 2014

Gynecomastia Surgery – 2015 Statistics From The American Society of Plastic Surgeons Reported.


Once a year, the American Society of Plastic Surgeons (ASPS) publishes the surgical statistics of their 7,000 Board Certified members. The statistics reflect an increase of 2% in 2015 from the previous year for both cosmetic and reconstructive procedures. The data reveals trends in surgery.


15.9 million surgical and non-surgical procedures were performed in 2015. Many cosmetic procedures showed an increase from 2014, such as 5% for liposuction, 9% for tummy tucks, and 5% for male breast reduction (gynecomastia). Overall breast reduction cases numbered at 68,106 with 40% of the procedures being for men!


Gynecomastia specialist, Dr. Miguel Delgado, M.D. notes that his gynecomastia cases increase each year. Dr. Delgado attributes the increase to the acceptance of cosmetic surgery for men. Not long ago men felt very uncomfortable even acknowledging their enlarged male breasts to others and themselves. Having enlarged male breasts caused a lot of humiliation and shame for many men.


Fortunately, with extensive coverage of gynecomastia through various media outlets, mostly the internet, men have come to accept the fact that a high percentage of men suffer from the same condition and are more likely than ever to seek resolution.


One of the most popular websites for information is The site offers forums where questions can be asked to member surgeons and chat rooms for sufferers of gynecomastia. Additionally, there is a directory by state, of Board Certified Plastic Surgeons who specialize in male breast reduction. Many of the surgeons have posted before and after pictures of their patients. Educational videos are available for viewing, of which many of which by Dr. Delgado.


For more information about gynecomastia surgery, call or email today for a consultation with Miguel Delgado, M.D.