August 17th, 2010
DOES SMARTLIPO OR ULTRASONIC-ASSISTED LIPOSUCTION WORK FOR GYNECOMASTIA? 
This is a very good question and one that is often asked in consultation. I have used ultrasonic liposuction and I continue using it today for liposuction. However, I do not use SmartLipo or ultrasonic liposuction with my gynecomastia cases. The reason I do not use ultrasonic-assisted liposuction is because in some cases the ultrasonic heat will cause some undue trauma to the skin and can be difficult to control. Therefore, I do not use the ultrasound in the chest itself; however, I do use it sometimes in the axillae (under the arms) for extraction of that fat. I think that it is a mistake to use ultrasound or SmartLipo to treat gynecomastia only. These modalities will treat the fat well, but will not extract the glandular tissue and, therefore, it will remain and the patients seeking male breast reduction, in most cases, are not happy with the results. Approximately 25%-30% of my gynecomastia practice is redo surgeries from other establishments and the primary reason is that a patient has had liposuction only. Due to the scar tissue caused by liposuction, the corrective surgery may be more difficult and sometimes the contraction of the skin is a little bit more unreliable when liposuction has been done first. The liposuction is very adequate for patients that have pseudogynecomastia, which is gynecomastia due to fat accumulation. This would be caused by weight gain in men or boys past puberty. Therefore, my suggestion is that if you do not have pseudogynecomastia, that a combination of liposuction, whether SmartLipo or ultrasound or tumescent liposuction, in conjunction with glandular excision is the best means for a good outcome. In some cases, you can do the light gynecomastia technique with a small incision depending on the extent of the gynecomastia, as explained in an earlier blog dated March 31.
MIGUEL A. DELGADO, M.D.
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July 6th, 2010
The Most Informative Website for Gynecomastia
MERLE YOST
The search engines are invaluable in helping one to find information on almost any topic. Gynecomastia has recently come to the forefront of awareness for many. Still there are those that are only just discovering that this is a treatable condition. No longer to be hidden from friends and loved ones, many are now speaking out about this embarrassing condition and what options men have. Gynecomastia, also known as; man boobs, moobs, male breasts, is becoming recognized as more and more men have successfully had surgery to correct the abnormal enlargement of the male breast.
Dr. Delgado endorses www.gynecomastia.org as the leader in bringing the most valuable information on gynecomastia to men. Merle Yost started the website in 1999 and it has expanded and improved through the years. You do need to sign up to take part in the forums, but there is no charge. This will give you the ability to ask questions and state frustrations to many who have had the same experience. Besides the forums, there are many categories to explore. There is a referral section where you can find board certified plastic surgeons in your area that are trained in gynecomastia. If there is not one in your area, Dr. Delgado offers a free travel package to help defer costs for his patients. Also listed are medical articles, treatment options, and a gallery of before and after photos and more. Dr. Delgado encourages all his patients to become familiar with www.gynecomastia.org but welcomes any unanswered questions or concerns to be brought to him.
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June 5th, 2010
HOW TO PICK A SURGEON FOR YOUR GYNECOMASTIA SURGERY
Gynecomastia surgery, or male breast reduction, is a specialty in plastic and reconstructive surgery.  Dr. Delgado believes that in picking a surgeon for your surgical procedure is much like picking real estate, which is location, location, location and for gynecomastia surgery it would be experience, experience, experience and a caveat of that is pictures, pictures,
and pictures. That is, before and after pictures will show you the volume that a doctor actually does as well as his artistic eye for the procedure.
A board-certified plastic and reconstructive surgeon is the best-qualified physician for performing this surgery. This is not a guarantee for a great result, but it is the gold standard for which provides the best training for plastic surgeons. Dr. Delgado is board-certified by the American Board of Plastic Surgeons and a member of the Aesthetic Society. He has vast experience with gynecomastia and breast reduction surgery.
Dr. Delgado feels that often more than one consultation with a plastic surgeon is in your best interest, be sure to have all your questions written down when you go in for a consultation as it is easy to forget when you are face to face with a surgeon. Keep careful notes so you can compare later. Be sure to note how much time the surgeon spends with you and if you feel all your questions were answered completely and to your understanding. Be sure you feel comfortable not only with the surgeon, but his entire staff as you may be spending a lot of time with them. If your surgeon has his own surgery center ask for a tour, notice if it is clean and organized.
Personal recommendations are always a good way to find a surgeon, however not too many men talk about their gynecomastia procedure, however there are some good websites available with lots of information. One specific website that Dr. Delgado recommends is http://www.gynecomastia.org/ it has a vast amount of information and forums for men to discuss not only their issues, but their surgical outcome and their experiences with doctors around the country.
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May 5th, 2010
WHAT MAKES FOR A SUPERIOR SURGERY CENTER?
Almost as important as finding an excellent surgeon for your gynecomastia procedure; is finding the surgeon who has an outstanding team and facility.
In 2001, when Dr. Delgado moved his practice to the medical building at the Sutter Novato Medical Campus, it was his plan to construct a private surgery center of the highest standards. It has been his ongoing mission through the years, to keep his “state of the art facility” a center that instills confidence in his patients that they are in a safe and comfortable environment.
Marin Cosmetic Surgery Center is fully accredited by Medicare and Quad A (American Association for Accreditation of Ambulatory Surgery Facilities, Inc.). 
One of the biggest advantages for a surgeon to have his own surgery center is quality control. Dr. Delgado’s surgical team is handpicked by him, and the fact that many of his employees have been with him for many years is a testimonial to their dedication to him and to each other. His team has done hundreds of gynecomastia (male breast reduction) procedures with him, allowing him to focus on the patient with the knowledge that his team is in full “sync” with him. Another very important factor is quality control of all instruments and medical supplies; this is something that Dr. Delgado monitors very closely. He has ongoing meetings with medical representatives to be sure he is up to date on all of the latest in all medical devices.
In a private surgery center the patient feels a sense of privacy that would not be felt in a hospital setting that has multiple operating rooms and a multitude of staff. When you have only one surgical case for everyone to focus on the level of care is ultimate.
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April 12th, 2010
THE IMPORTANCE OF A SUPPORT SYSTEM
The onset of gynecomastia, in most cases, starts at puberty. Gynecomastia today is known by many as “moobs” (man boobs). If a boy is evaluated by his doctor at this time, he will most likely be told that he will outgrow this condition in a year or two. In many cases this is true; however at such a young age a year or two seems like forever, especially with a condition that can be the source of cruel taunting from classmates. How does a boy undress for gym, go to the beach, play skins vs. shirts, and have a “normal” life in the meantime? The feeling of isolation and wondering “what is wrong with me?” can be the cause of unbelievable emotional stress and depression. If they are among the more fortunate boys, they will outgrow the condition and will be able to go on with a normal life. Unfortunately, in many cases young boys do not outgrow this condition and it can become a lifelong source of continual embarrassment and adjustments in their lifestyle.
Many boys will try to hide their condition even from family members, due to embarrassment or thinking that it is their own fault. It takes a very aware parent or family member to identify the source of their child’s misery. Not all boys with gynecomastia have emotional issues; some manage to lead a normal life. But for many who are approaching puberty and are seeing changes in their body, having their breasts develop can be a very frightening experience. Imagine at such a young age going to your parents and asking for help, not knowing if there even is anything that can be done. Dr. Delgado is able to tell, in most cases, if a boy will outgrow his gynecomastia, or if it is more permanent.
We know of such a patient who went to his father while in High School and asked him, if instead of spending money on college, if he could have corrective surgery. His Father was shocked to find that his son was so miserable, he had no idea! The father took out a line of credit; his son had gynecomastia surgery and was able to go on to college.
Not all stories have such a happy ending. Some boys do not have a supportive family member who can understand the agony they go through. You never know unless you try, many parents step up to the plate when presented with the problem. However, for those who do not have support at home, I would like to recommend a source of outside support. At www.gynecomastia.org you will find many men of all ages facing the problems and emotional issues that gynecomastia can present. There are chat rooms and forums where almost all subjects are addressed. It is free to sign up, you will be allowed to post questions and concerns, and you will be amazed at the support you will find from others who have faced similar situations.
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