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1. Is there any nonsurgical treatment for gynecomastia?
Although you can read about easy, non-surgical cures in the news and advertisements and there is considerable ongoing research aimed at finding a way to reverse it without surgery, no effective medical treatment actually exists at this time.
2. Is liposuction adequate treatment? I do not want a surgical procedure.
Liposuction alone is not a good treatment for gynecomastia. Only with cases of pseudogynecomastia is it an adequate technique. Removing the fat around the gland only creates an unnatural bulb and patients are not satisfied with the aesthetic result from this technique. Redo surgery from other establishments comprises 25-30% of Dr. Delgadoís practice and most of these cases have had liposuction alone.
3. Will the entire gland be removed during the surgery?
Not necessarily. Male breast reduction surgery for gynecomastia is a cosmetic procedure. Therefore, enough is removed to create a good looking, flat, but contoured chest. Sometimes the entire gland is removed and sometimes only 80% or 90% is removed. After surgery, Dr. Delgado is happy to discuss this aspect of your procedure with you.
4. Will it come back after surgery?
Rarely, but the tissue can be still stimulated and enlarged by steroids or other medication use. Of course, weight gain can increase the fat content of the overall chest and body. Gynecomastia seldom returns if enough of the gland is removed during the surgical procedure.
5. Will insurance pay for the gynecomastia surgery?
This is a very difficult question to answer even though Dr. Delgado has dealt with insurance companies on hundreds of occasions. It is unusual that gynecomastia reduction surgery is covered, even in the most severe and unfortunate cases. Most insurance companies consider it cosmetic surgery. Dr. Delgado has occasionally received approval for cases in which a medical condition or syndrome has caused the gynecomastia. Even symptoms of pain and tenderness usually fail to warrant coverage in the opinion of the insurance carrier.
Nevertheless, Dr. Delgado is always willing to write a letter and send photographs to the insurance carrier on behalf of the patient, with the hope that insurance coverage for the surgery might be granted.
6. Is it painful?
Gynecomastia reduction surgery is not particularly painful. Most men find they need pain pills for only two or three days. Drain removal can be a little uncomfortable, but recent, improved techniques have made it less so.
Will the nipple sensation be lost?
With surgery, it is always possible to have a change in nipple sensation. Some patients have reported changes in sensation, but most do not mention it. Merle Yost of gynecomastia.org has surveyed men who had gynecomastia surgery and a change in nipple sensation is one of the subjects addressed in his survey. If you sign onto the site, gynecomastia.org, you can read comments by post-surgical patients regarding the changes they have experienced with nipple sensation.
Of patients who underwent the combination of liposuction and surgical excision of gynecomastia, the approach most often used by Dr. Delgado, 21 reported no change in nipple sensation and 29 reported there was a change in nipple sensation. Two of the patients who reported a change said that they had an improvement in nipple sensation. Twenty-seven patients reported a loss of sensation ranging from 0.5% to 100%, with the average loss some being 37%.
Remember, this is a survey and not a scientific controlled study. It does, however, offer interesting information.
8. How much does it cost?
Costs depends on the complexity of the surgery. Gynecomastia reduction surgery at Marin Cosmetic Surgery Center is always done with a board-certified physician anesthesiologist, never under local anesthesia. Our facility has national and state accreditation as an outpatient surgery center. These are important facts to consider when comparing costs with various providers. Cost usually ranges between seven thousand five hundred to ten thousand dollars.
9. What could go wrong?
This is real surgery and the risks associated with that cannot be overstated. Bleeding under the skin is one of the most common complications. It used to occur in about 8-9% of patients, but over the past three years we have been able to reduce that figure to approximately 5-6%. We now require blood clotting tests and prescribe a regimen of Vitamin K to boost the bodyís clotting mechanism. We advise patients to stay at a local hotel if they live over an hour away.
Complications do occur. This is a fact in the practice of medicine. It is how the complications are managed and handled that determines the outcome. Dr. Delgado has vast experience with complications associated with gynecomastia and is very comfortable in treating them.
Over or under resection of tissue can occur. Under resection can be handled with re-excision, but over resection requires fat injections to the involved area.
10. When can I go back to work?
After gynecomastia surgery a person can drive a car within a few days and can return to school or work within a week. (If a personís work is physically demanding, two weeks of recovery will be needed.) Formal exercise regimens should not be resumed until six weeks after surgery.
11. What is the policy if I am not happy?
Dr. Delgado's goal is to have you be extremely satisfied with your results. If a revision is needed and it can be performed in the office, he will do it at no charge. If general anesthesia is required, Dr. Delgado does not charge the patient for his services, but there may be a fee for the surgery center and the anesthesiologistís services.
Please take the time to contact us by phone at: (415) 898-4161 or by filling out the form below:
SAN FRANCISCO OFFICE
450 Sutter Suite 2433
San Francisco, CA 94108
165 Rowland Way Suite 300
Novato, CA 94945