Man Boobs: Causes and Cures

Serving Men in San Jose, Mountain View, and the Bay Area

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Gynecomastia is a medical term that comes from the Greek words for “women-like breasts.” Though this oddly-named condition is rarely talked about, it’s actually quite common. Gynecomastia affects an estimated 40 to 60 percent of men. It may affect only one breast or both.

For men who feel self-conscious about their appearance, breast-reduction surgery can help. The male breast reduction procedure removes fat and or glandular tissue from the breasts, and in extreme cases removes excess skin, resulting in a chest that is flatter, firmer, and better contoured. Some patients may also experience physical relief; excessive breast tissue can cause skin chafing, irritation and even infection. View before and after results from actual Bay Area patients who have received gynecomastia treatment at Pearl – Ereso Plastic Surgery Center.

If you suffer from gynecomastia, contact our Mountain View-based plastic surgery center, serving Los Altos, Sunnyvale, San Jose and the entire Bay Area.

What Causes Gynecomastia?

It is not entirely known what causes gynecomastia. Doctors believe the condition may be caused by any of the following:

  • Hormonal imbalance resulting in excess female hormones
  • Certain medical conditions such as liver failure and malnutrition
  • Use of anabolic steroids
  • Medications used to treat certain medical conditions
  • Drug or alcohol use

Male Breast Reduction Candidates

Surgery to correct gynecomastia can be performed on healthy, emotionally stable men of any age. The best candidates for surgery have firm, elastic skin that will reshape to the body’s new contours.

Surgery may be discouraged for obese men or for overweight men who have not first attempted to correct the problem with exercise or weight loss. Also, individuals who drink alcohol beverages in excess or smoke marijuana are usually not considered good candidates for surgery. These drugs, along with anabolic steroids, may cause gynecomastia. Therefore, patients are first directed to stop the use of these drugs to see if the breast fullness will diminish before surgery is considered an option.

If you feel you are a good candidate for the surgical treatment of gynecomastia, contact Drs. Samuel Pearl and Alexander Ereso in Mountain View, California at their private cosmetic plastic surgery practice, which proudly cares for the entire Bay Area’s cosmetic surgery needs.

Your Personal Gynecomastia Consultation

A personal consultation is the first step. Dr. Pearl or Dr. Ereso will assess your physical and emotional health and discuss your specific cosmetic goals for surgery.

You should arrive at the consultation prepared to provide complete information about:

  • Previous surgeries
  • Past and present medical conditions
  • Treatments you have received
  • Medications that you are taking, including nutritional supplements and herbal remedies

To arrange a consultation to discuss treatment of gynecomastia, contact our Mountain View-based cosmetic plastic surgery practice, a convenient drive from Palo Alto, San Jose, Los Altos, and the surrounding Bay Area communities.

The Male Breast Reduction Procedure

As the male breast ages, usually the fatty component increases and the glandular component decreases. This fact has helped to make ultrasound assisted liposuction the mainstay of modern gynecomastia surgery. After ultrasound and hi vacuum standard tumescent liposuction has been completed, any remaining glandular tissue can be removed by placing a small incision around the lower edge of the nipple areolar complex.

Combining sophisticated liposuction techniques and excisional surgery as necessary has resulted in inconspicuous scars and outstanding improvement in producing natural appearing male shaped breast contours.

It should be noted that adolescent and young men who have gynecomastia surgery usually have a significant glandular component making sculpted excision the main focus of the treatment. Liposuction is then used to fine tune the shape of the breasts and chest, producing a natural, pleasing shape.

Remember, artistic talent is an important part of plastic surgery, and Drs. Pearl and Ereso are well known in Mountain View, Palo Alto, Sunnyvale, San Jose, and throughout the Bay Area for their artistry.

For information on gynecomastia surgical treatment, contact our knowledgeable staff in Mountain View, California.

Male Breast Reduction Recovery

You will feel some discomfort for a few days after surgery. However, discomfort can be controlled with medications prescribed by your surgeon.

To help reduce swelling, you’ll probably be instructed to wear an elastic pressure garment continuously for several weeks, and for a few weeks to several months longer at night to obtain the best result. Although the worst of your swelling will dissipate in the first few weeks, it may be three months or more before the final results of your surgery are apparent.

Dr. Pearl or Dr. Ereso will advise you to avoid sexual activity for 1-2 weeks, and heavy exercise for about three to four weeks. You’ll be told to stay away from any sport or job that risks a blow to the chest area for at least three to four weeks. In general, it will take about a month before you’re back to all of your normal activities.

Avoid straining, bending and lifting during the early postoperative period. You may resume most of your normal activities within ten days or less.

Male Breast Reduction Results

Gynecomastia surgery can enhance your appearance and self-confidence, but it won’t necessarily change your looks to match your ideal. Before you decide to have surgery, think carefully about your expectations and discuss them frankly with Drs. Pearl and Ereso.

The results of the procedure are significant and permanent. If your expectations are realistic, chances are good that you’ll be very satisfied with your new look.

By contacting our plastic surgery practice, Sunnyvale, Los Altos, San Jose, and Bay Area residents can learn more about the treatments for gynecomastia offered at our Mountain View-based, fully equipped surgical facility.

Kybella Non-Surgical Injectable Now Available

The Pearl – Ereso Plastic Surgery Center is pleased to announce an exciting new addition to our non-surgical treatments: Kybella injectable treatment. This revolutionary FDA-approved treatment is used to dissolve extra fat under the chin (i.e., a “double chin”). Learn more about this exciting and safe new treatment, performed by both Dr. Samuel Pearl and Dr. Alexander Ereso, in this post.

What Causes a “Double Chin”?

Many factors can contribute to a person having a “double chin,” including being overweight or obese. However, a person who is otherwise slim may still have extra fat below their jaw line as a result of genetics or aging, which causes the skin in the area to droop over time and create this unattractive effect.

How Can Kybella Help?

Kybella is made from a naturally occurring molecule in the body called deoxycholic acid. Upon injection into the chin area, Kybella targets and then destroys the fat cells in the area. Once these fat cells are eliminated and then absorbed naturally by the body after treatment, new fat cells cannot rejuvenate and store fat in the area. The result of treatment, then, is a slimmer, more well-defined jaw line — and without any incisions, stitches or scarring!

What is a Kybella Treatment Like?

A Kybella treatment plan usually consists of two to six sessions of injections, depending on the needs of the patient. Each session, which typically lasts 15 minutes, is spaced between four and eight weeks apart. To start off your treatment, Dr. Pearl or Dr. Ereso will apply a topical numbing agent on the chin and jaw area, so that you do not feel the injection. The doctor will use a small syringe to inject Kybella into the fattiest areas of the chin for the best aesthetic outcome.

Once the Kybella session is done, a small amount of redness and irritation in your chin area is expected, though minor. There will also be some mild swelling in the area, which usually subsides after a couple of days. Downtime is minimal after treatment; you can expect to return to normal daily life, including going to work and exercising, after a day or two.

The Best Part: The Results!

You should expect to see a noticeable improvement in your chin and jaw line appearance after about a month of treatment. The results, though gradual, are marked, with chin fat that appears to dissolve slowly before your very eyes! Final results can be expected after three to four months, or after about three or four treatment sessions. And the best part is that these beautiful, natural-looking results can last a lifetime!*

*Kybella results are permanent. However, fat can return to the chin area if a patient gains weight after being treated. But since a Kybella treatment permanently destroys and removes fat cells in the chin area, these cells cannot rejuvenate to store fat. Any added weight, therefore, will be more evenly distributed throughout the face and neck area.

Find Out if Kybella is Right for You

Are you ready to learn more about the innovative Kybella treatment? One of our doctors at the Pearl – Ereso Plastic Surgery Center would be happy to answer your questions. To schedule a consultation with Dr. Pearl or Dr. Ereso, contact the Pearl – Ereso Plastic Surgery Center by calling (650) 964-6600.

Want Fuller Lips? Your Surgical and Non-Surgical Options

What woman doesn’t want a fuller, more sensuous pout? In this blog post, the team at Pearl – Ereso Plastic Surgery Centerhas a few tips — some involving injections and some not — on how to get lip-plumping effects for both the short- and long-term.

Create a Fuller Look with Makeup

Makeup is a handy tool that, when used expertly, can create the illusion of fuller lips. You can achieve this by first hydrating your lips with a lip balm. Next, use a light nude-colored pencil to fill in the middle portion of your lips (the width of your cupid’s bow) from top lip to bottom lip. Be sure to stay within your natural lip lines. Next, take a darker-colored nude pencil to outline your lips and fill the outer corners, blending the edges with your finger as you go. Finally, apply sheer lipstick or lip gloss to your lips. The result? Gorgeous, full-bodied lips.

Use a Toothbrush on Your Lips

The lips, like the rest of your skin, benefit from regular exfoliation. This will both rid the lips of dead skin cells and stimulate blood flow to the area, causing them to plump. The best way of doing this is to use a dry, soft-bristled toothbrush on your lips to gently exfoliate them. For the best results, apply petroleum jelly to the brush so that your slightly plumped lips are also softer and smoother after this home treatment. You can also use a paste made of sugar and water to exfoliate the lips further as you brush. Once done, apply a soothing, hydrating lip balm to your lips. Your lips should appear softer and fuller instantly.

Try Lip Augmentation

Other lip-plumping techniques, like the ones mentioned above, may be perfect for a night out, but some women want their fuller lips to last months instead of hours. For these women, a non-invasive procedure like lip augmentation is the perfect “lunch hour” procedure, taking less than 20 minutes to complete and requiring zero downtime afterwards. In his lip augmentation procedure at Pearl – Ereso Plastic Surgery Center, Dr. Pearl offers the option of using a hyaluronic acid filler (such as Restylane, Perlane or Juvederm) or the patient’s own fat (that has been processed and refined) for injection. Both techniques have their advantages and disadvantages, which Dr. Pearl can discuss with you during your consultation. In either case, the results look natural and can be expected to last for up to eight months.

Get More Facts about Lip Augmentation

Are you curious to learn more about how you can achieve fuller yet natural-looking lips? Why not talk to a doctor at Pearl – Ereso Plastic Surgery Center? To schedule a personal consultation with Dr. Samuel Pearl or Dr. Alexander Ereso, call Pearl – Ereso Plastic Surgery Center at (650) 964-6600.

Dr. Ereso : De Maio Master Injector

Earlier this month, Dr. Alexander Ereso completed an advanced master class on injection techniques for JUVÉDERM Voluma in San Francisco. Dr. Ereso is one of a few physicians who were handpicked to attend the course which was taught by the renowned Brazilian plastic surgeon, Dr. Mauricio de Maio. Dr. de Maio is considered a pioneer, and an expert in the field of injectable medicine, and he lectures around the world to his peers about JUVÉDERM Voluma. The course was sponsored by Allergan, the company that makes Botox, JUVÉDERM XC, Latisse, and JUVÉDERM Voluma. Dr. Ereso attended the event to not only further develop his considerable skills, knowledge and experience, but also, to incorporate these new and exciting techniques in his day-to-day treatments.

The all day course, which featured didactics as well as live injections featured Dr. de Maio’s innovative new injection technique designed to revolumize age-related volume loss, add structure to the midface, and provide balance to the whole face. By strategically injecting JUVÉDERM Voluma in a few key locations including the upper outer cheek, a subtle yet natural aesthetic lift can be achieved instantly.

JUVÉDERM Voluma is a facial filler that has been FDA approved for use in the U.S. with clinical trials showing that it lasts up to 2 years. It is the first and only FDA-approved Hyalronic Acid filler for the midface, designed to temporarily correct age-related volume loss in the cheek area, thereby restoring definition to the cheek area. As result of restoring volume to the mid check, you can see an immediate lift in the jowl area, resulting in a more youthful appearance.

Computer Imaging Provides a Preview of Facial Plastic Surgery

It is normal for facial plastic surgery patients to feel hesitant or nervous about their results. Though Drs. Samuel Pearl and Alexander Ereso are skilled, experienced plastic surgeons any surgery performed by any surgeon involves an element of the unknown. Our doctors understand this, and offer special technology to help alleviate some of these patient concerns and improve the predictability of the surgical outcomes.

Computer imaging allows our facial plastic surgery patients to envision how they will look after surgery. This technology works for patients who are seeking to have a specific feature (e.g., nose, eyes) corrected, or have requested allover facial rejuvenation.

Computer imaging is a valuable part of the treatment planning process, as it improves the communication between doctor and patient. Also, it helps the patient develop realistic expectations of the surgical outcome. And, it is a helpful teaching tool for our doctors.

How Computer Imaging Works
First, a member of our team will take photographs of your face, likely from the front angle and the profile view. The images will then be loaded into our office computer and the special digital imaging program. Then, Dr. Pearl or Dr. Ereso will manipulate the image as you watch alongside them, to simulate what surgery will accomplish.

For example, if you have requested rhinoplasty to improve the look of your nose, the doctor may digitally tweak your nose to make it look thinner or straighter. Or, if you are planning eyelid surgery to remove wrinkles and bags underneath your eyes, he can digitally remove those imperfections.

As the doctor alters the photographs, you can provide your feedback and suggest changes or improvements.

When you and the doctor are happy with the modified digital image, it will be saved in your file, and emailed or printed out for you to take home. You are free to share the image with family or close friends to get their feedback.

Keep in mind that the digital images are not meant to be 100 percent accurate, in terms of how your results will look. It is impossible to predict with complete certainty what you will look like after surgery, but your digital images will be very close.

Preview Your Results
Are you interested in a facial plastic surgery procedure? Would you like to preview the possible results? If so, please contact the practice of Dr. Samuel Pearl and Alexander Ereso and schedule a consultation. Call (650) 964-6600 or send us an email at

Dr. Pearl’s Voluma Results

Details: Dr. Pearl had 3cc Voluma and 2cc Juvederm Ultra Plus injections over two treatment sessions, spaced six weeks apart. Both procedures were performed with topical anesthetic and a small amount of local anesthetic injected prior to the Voluma and Juvederm.

As you can see, Dr. Pearl noticed excellent improvement with rejuvenation of the malar cheekbone area.



Learn More about Voluma

Would you like more information about Voluma or another non-surgical facial rejuvenation treatment? Please contact our office today by calling (650) 964-6600.

What Are My Nonsurgical Treatment Options?

Over time, the body produces less and less collagen and elastin, two proteins that are vital for healthy, elastic skin. Without a sufficient amount of these proteins, the skin loses its elasticity and starts to sag. In addition, outside factors, including major weight loss, constant sun exposure, hereditary traits and certain lifestyle habits such as smoking, can contribute to sagging facial skin as well as other visible signs of aging and environmental damage on the face.

Thankfully, Dr. Samuel Pearl and Dr. Alexander Ereso offer a wide range of nonsurgical facial rejuvenation treatment options to help combat noticeable signs of aging and sun damage on the face. The following are a few of the most popular nonsurgical cosmetic treatments requested at Pearl – Ereso Plastic Surgery .

BOTOX Cosmetic

BOTOX Cosmetic treatment continues to be one of our most requested nonsurgical treatments. When injected, BOTOX Cosmetic temporarily stops muscle activity in the treatment area, thereby relaxing and smoothing out the overlying wrinkles. BOTOX is great for use in smoothing out forehead furrows, frown lines in between the eyebrows and crow’s feet, among other uses. Results last about four months before an additional treatment is needed to maintain the rejuvenating results.

Dermal Fillers

There are several types of dermal fillers available at Pearl – Ereso Plastic Surgery , including Juvéderm, Restylane, Perlane, Radiesse and Sculptra. They are used to fill in — and thus smooth out — wrinkles and lines on the face, including smile lines and frown lines. Dermal fillers can also be used to restore volume in areas of the face that lack fullness, such as the cheeks. Some of them can even be used to enhance certain facial features, including the lips.

Laser Skin Resurfacing

With Fraxel laser skin resurfacing treatment, patients can achieve improved skin texture, more even pigmentation, an improvement in the look of wrinkles and fine lines and a subtle skin tightening effect on the face, neck, chest and hands. This treatment option is especially beneficial for individuals who would like to improve the look of dark age or sun spots, freckling or areas of redness.

SilkPeel Dermalinfusion

SilkPeel Dermalinfusion treatment is performed to slough away the upper layer of dead, dull skin cells to reveal the fresher, healthier skin underneath. Its effects are similar to those of microdermabrasion treatment, but SilkPeel Dermalinfusion does not require the use of harsh abrasive particles like microdermabrasion does. In addition, SilkPeel Dermalinfusion treatment infuses the skin with a nourishing solution that leaves patients with refreshed, healthier-looking skin. This treatment is an effective way to improve the look of hyperpigmentation, dehydration, fine lines and wrinkles, uneven skin texture and acne scarring.

Find Out More

Our nonsurgical cosmetic treatments are a great way to rejuvenate the face and help stave off the need for cosmetic facial surgery. They can also be used to optimize the aesthetic benefits of cosmetic surgery. To schedule a consultation with Dr. Pearl or Dr. Ereso to find out more about your nonsurgical facial rejuvenation treatment options, please contact Pearl – Ereso Plastic Surgery by calling (650) 964-6600.

What Do You Do With Noses That Grow with Age? Alternatives to Nose Surgery

It’s true that noses enlarge with age. Why, you may ask? Noses may appear to grow as bones surrounding the area of the nose recede. Numerous studies have been performed to better understand the changes in bones and cartilage of the nose. There are some marked differences between women and men, including:

• In women, the size of top of the T-Zone area between the eyebrows at the top of the nose decreases. In addition, the eyebrows recede. Finally, the nostrils become enlarged, the tip may droop and the cheeks slide down forward. All factors contribute to the nose appearing much larger.
 • In men, the size of support for the cheeks (bones and tissue) decreases. The eyebrows sag and may tend to hang low. This combination creates the appearance of an enlarged nose. Interestingly enough, the plastic surgery community has developed some creative solutions for women and men that are interested in simple refinements of the nose, but not necessarily nose surgery, as follows:
• Facial fillers and injectibles may be used to add volume to areas of the face surrounding the nose. This in turn, creates the impression that the nose is smaller. Alternatively, women and men interested in refining their nose may do so through plastic surgery that may involve removing excess fat and skin from the surrounding cheek area to create the appearance of a smaller nose.
• There are also surgical options for the nose that does not involve surgery on the nose. Particularly, the area surrounding the nose may require bone grafting or facial implants to refine the appearance of the nose.

Indeed, there are several options available today to refine the appearance of the nose. Not all plastic surgeons focus on every treatment option available for nose enhancement. Plastic surgeons that focus on injectibles, facial implants, and nose surgery are often some of the best types of plastic surgeons to visit to learn more about the varying options for nose surgery.

For more information about rhinoplasty visit Dr Samuel Pearl’s site here..