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, San Mateo County and San Mateo since 1988.