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.



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

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.

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.


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.

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.


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.


The Dangers of Gynecomastia Surgery and Smoking


“Why Smoking Endangers the Gynecomastia Patient”


san jose gynecomastia-smoking


Preparing for gynecomastia surgery depends on the cooperation of the patient. Miguel Delgado, M.D. is very thorough in giving his patients instructions and what to expect from their surgery. Planning for cosmetic plastic surgery is a very exciting time, but it is easy to forget verbal instructions. Therefore, Dr. Delgado gives all of his patients a detailed pre and post-operative booklet. Patients that adhere to the instructions are the ones that will get the optimal results.


Smoking has proved to be a great detriment for surgery patients. In fact, the complications are so serious that many studies have been done to determine the effect of cigarette smoke during and after surgery. One such study done by the American Society of Anesthesiologists revealed smokers were at 50% greater risk for developing pneumonia than non-smokers, and the percentages increase for other complications, such as; 57% greater risk for cardiac arrest, 73% for stroke and a whopping 80% higher risk for a heart attack.


Additionally, the European Society of Anesthesiology reported that smokers require 33% more anesthesia and 23% more pain medication than a nonsmoker. Patients exposed to second-hand smoke will need 20% more anesthesia and 18% more pain medication.


Smoking and Gynecomastia Surgery is a bad combination.


Smokers must abstain from smoking for two weeks before and two weeks after surgery. Of course quitting permanently would be ideal; however nicotine addiction is extremely difficult to kick. Miguel Delgado, M.D. has helped many patients who smoke reach their surgery goals by prescribing medications such as Chantix.


Understanding why smoking can cause such havoc for the cosmetic surgery patient may help the smoker abstain for the required time. There are more than 250 toxins in cigarette smoke in addition to nicotine! Among these toxins are; hydrogen cyanide, carbon monoxide, and nitric oxide, all of which will interfere with wound healing. Oxygen is transported to the tissues by the blood vessels; the oxygenated blood is needed to fight infection by delivering medication and antibiotics.


When smoke is ingested, the blood vessels constrict and blood clots may form. If there is a reduction in the blood going to the tissues, cell death may results causing what is known as necrosis, and inflammation of the surrounding tissues. When necrosis occurs, debridement may be necessary. Debridement is surgical removal of the dead cells, and the ultimate result may be disappointing.


Patient safety and exceptional surgical results are essential to Dr. Delgado, call now (415) 898-4161 or email for a consultation.

Gynecomastia.Org – A Great Resource for Information



In 1996, the website was created. Merle Yost, a psychologist and previous sufferer of male breasts realized there was very little information available for men who have gynecomastia. He contacted Miguel Delgado, M.D. to collaborate with him in the creation of an informational website that would educate men and give them a venue for getting answers to their numerous questions.


Through the years, the website evolved to becoming the most popular source of man boob information on the internet. In 2010, Merle Yost decided to sell the website as maintenance became too time consuming.  Miguel Delgado, M.D. didn’t want to see the site lose its integrity, so he purchased the site.


If you look up gynecomastia on the popular search engines such as;,, and, you will see that is on the first page of the organic listings. The website remains free to members; however registration is required so that insensitive or abusive content can be controlled. There is a fee to the surgeons who are members and these fees help to fund the maintenance of the site. Member surgeons are all Board Certified Surgeons who have a special interest in gynecomastia surgery. Many of them donate their time to answer questions that are posted by the forum members.


There are multiple gynecomastia forums on the site that cover many topics such as;


  • Gynecomastia Talk (which is the most popular with daily posts),
  • Stories
  • User Diaries
  • Fat and Gynecomastia
  • Puffy Nipples
  • And many more.


New threads are frequently started as old and new members submit questions and relate experiences. The support men offer each other is something you won’t find anywhere else. As men reveal the shame they have felt, they learn they are not alone and find a great deal of solace from the men on the site.


In addition to the forums, the website offers a directory of gynecomastia specialists from all over the United States, and beyond. There are FAQ’s, Scientific Articles, Videos, Photo Galleries and Blogs.


If you haven’t discovered and suffer from male breasts, Miguel Delgado, M.D. invites you to explore the site. If you are in the San Francisco Bay area and want a personal consultation with Dr. Delgado, please call (415) 898-4161 or email If you are from out of town, see Dr. Delgado’s generous offer by clicking on this link.

Before and After Pictures of Gynecomastia Patient’s Show a Surgeon’s Skill

Gynecomastia before and after photos |San Jose, CA

gynecomastia B&A
San Jose, California: This is a 21-year-old male who presents with gynecomastia to the San Francisco, California office and presents for gland excision and suction assisted lipectomy as well as a superior areola crescent lift due to the laxity of his skin. His gynecomastia surgical treatment was performed in Marin County California at Marin Cosmetic Surgery Center in Novato, California. His post op photographs are seen approximately 3 months after surgery.

San Jose, California-Most surgeons take before and after pictures of their patients. Board Certified Plastic Surgeons receive special training in photography due to the importance of this documentation which assists them in surgical planning. Beyond surgical planning, the photographs are a useful tool for surgeons to show prospective patients the quality of their work. Many patients appreciate being able to see their before pictures to compare them to their surgical result.

For a man with gynecomastia, also known as man boobs, searching for a gynecomastia specialist can be daunting. There are many aspects for the man to consider. First, he needs to be sure the surgeon is Board Certified in Plastic Surgery. Second check out where the surgery is to be performed, hospital or surgical center and find out if it is accredited. If it is an accredited surgery center, he should ask for a tour and note if it is organized and clean.

A Gynecomastia Surgeon Photos are worth a thousand words.

During the consultation, the gynecomastia patient needs to ask lots of questions. Find out how many male breast reduction surgeries are performed per year. Ask the surgeon what method of surgery he or she plans. Unless the man has “pseudo-gynecomastia” (only fat and no excess breast tissue), the combination of liposuction and surgical excision is necessary. Liposuction alone will leave breast tissue behind, necessitating a secondary surgery to remove the breast tissue. In order to remember all your questions, it is advised to bring a list. Dr. Delgado encourages men to call or email with questions at any time.

Possibly one of the most important aspects to help a man determine the expertise of the gynecomastia surgeon is in the viewing of the surgeons before and after surgery pictures of actual patients. It is important to note that patients pictures that are posted on Dr. Delgado’s website or shown in albums at the time of consultation have all given their written consent. Patient’s privacy is highly respected, and those who are willing to share their photos with prospective patients are greatly appreciated, but definitely not required.

photographerIn viewing the before and after pictures, there are a few things to note that will help determine the accuracy of what you are looking at. There should be different angles taken of each patient; front view, oblique and side view. Almost anything can be made to look good from just one angle. The background should be consistent, a blank wall or a black drape works well. The person needs to be placed in the frame in the same position, with arms down at their sides, or in the same position, for both before and after surgery. In addition, color saturation and lighting needs to be the same or as close as possible, for easier comparison.

Bearing all these things in mind, it is understandable how difficult it can be for a man to choose the best top plastic cosmetic gynecomastia surgeon he can find. The effort will be well worth it, to be able to avoid revision surgery. The single most common cause for the need of a secondary surgery is where the initial surgeon mistakenly thinks that liposuction alone will remove the male breasts of a man with “true gynecomastia”. As mentioned earlier, liposuction will work for the man that has “pseudo-gynecomastia” which is caused by fat alone.

Dr. Delgado is pleased to offer men who have “pseudo-gynecomastia” an alternative to liposuction surgery, and that is CoolSculpting. CoolSculpting is a non-invasive treatment that reduces fat over a 2 to 4 month period. Fat cells are intensely chilled, at little to no discomfort for the patient, causing the fat cells to die and to be shed by the body. Patients love this new treatment for removal of fat from the male chest, abdomen and love handles. Since it is not a surgical treatment, there are no scalpels, incisions, sutures, or scars, allowing patients to return to their normal activities with no downtime. Men who are candidates for CoolSculpting will find that their gynecomastia costs are greatly reduced.

Men who suffer with moobs or male breasts are invited to schedule a consultation with Dr. Delgado to determine what surgical or non-surgical options are available to them by calling (415) 898-4161 or sending an email.