European Journal of Plastic Surgery

, Volume 35, Issue 1, pp 55–64 | Cite as

Gynaecomastia: considerations and challenges in treating male patients with varying body habitus

Original Paper
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Accepted:
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Abstract

The body habitus, age and expectations of men presenting with gynaecomastia are changing. Formerly, gynaecomastia presented mainly as a problem of post-pubertal males with incomplete resolution of physiological gynaecomastia. Now adults in their second to fourth decades present with breast enlargement from iatrogenic drug use, obesity, or with skin and fat excess following massive weight loss (pseudo-gynaecomastia). Adolescents present with obesity. By considering each enlarged component and addressing each in turn, it should be possible to reduce the breast to normal dimensions and form—the end point of this surgery being a masculine appearance. This article presents four patients with gynaecomastia but with widely varying body habitus. Surgical treatment for gynaecomastia involves the application of liposuction and/or open reduction. Two features are added to this standard surgical management to try and optimize surgical outcome: staged serial excision to minimise scars and the use of a preoperative checklist to establish realistic goals.

Keywords

Gynaecomastia Body habitus Peri-areolar breast reduction Staged serial excision 
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Notes

Acknowledgements

I would like to thank the medical photography departments at St John’s Hospital Livingston and Royal Sick Children’s Hospital Edinburgh for their support. Thanks are also due to Mr. Chris West, senior trainee in the Department of Plastic Surgery Edinburgh, for presenting this work in poster form at the Modern Concepts: Breast Aesthetics and Reconstruction Meeting 2010 Birmingham.

Conflict of interest

None

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Department of Plastic and Reconstructive Surgery EdinburghSt John’s Hospital HowdenLivingstonUK
  2. 2.Department of Plastic SurgeryRoyal Sick Children’s HospitalEdinburghUK

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