Advertisement

World Journal of Surgery

, Volume 32, Issue 1, pp 38–44 | Cite as

Surgical Management of Gynecomastia—a 10-year Analysis

  • A. E. HandschinEmail author
  • D. Bietry
  • R. Hüsler
  • A. Banic
  • M. Constantinescu
Article

Abstract

Background

Gynecomastia is defined as the benign enlargement of the male breast. Most studies on surgical treatment of gynecomastia show only small series and lack histopathology results. The aim of this study was to analyze the surgical approach in the treatment of gynecomastia and the related outcome over a 10-year period.

Patients and methods

All patients undergoing surgical gynecomastia corrections in our department between 1996 and 2006 were included for retrospective evaluation. The data were analyzed for etiology, stage of gynecomastia, surgical technique, complications, risk factors, and histological results.

Results

A total of 100 patients with 160 operations were included. Techniques included subcutaneous mastectomy alone or with additional hand-assisted liposuction, isolated liposuction, and formal breast reduction. Atypical histological findings were found in 3% of the patients (spindle-cell hemangioendothelioma, papilloma). The surgical revision rate among all patients was 7%. Body mass index and a weight of the resected specimen higher than 40 g were identified as significant risk factors for complications (p < 0.05).

Conclusions

The treatment of gynecomastia requires an individualized approach. Caution must be taken in performing large resections, which are associated with increased complication rates. Histological tissue analysis should be routinely performed in all true gynecomastia corrections, because histological results may reveal atypical cellular pathology.

Keywords

Male Breast Gynecomastia Atypical Ductal Hyperplasia Glandular Tissue Seroma Formation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Braunstein GD (1993) Gynecomastia. N Engl J Med 328:490–495PubMedCrossRefGoogle Scholar
  2. 2.
    Gabra HO, Morabito A, Bianchi A, et al. (2004) Gynecomastia in the adolescent; a surgically relevant condition. Eur J Pediatr Surg 14:3–6PubMedCrossRefGoogle Scholar
  3. 3.
    Colombo-Benkmann M, Buse B, Stern J, et al. (1999) Indications for and results of surgical therapy for male gynecomastia. Am J Surg 178:60–63PubMedCrossRefGoogle Scholar
  4. 4.
    Steele SR, Martin MJ, Place RJ (2002) Gynecomastia: complications of the subcutaneous mastectomy. Am Surg 68:210–213PubMedGoogle Scholar
  5. 5.
    Boljanovic S, Axelsson CK, Elberg JJ (2003) Surgical treatment of gynecomastia: liposuction combined with subcutaneous mastectomy. Scand J Surg 92:160–162PubMedGoogle Scholar
  6. 6.
    Fruhstorfer BH, Malata CM (2003) A systematic approach to the surgical treatment of gynecomastia. Br J Plast Surg 56:237–246PubMedCrossRefGoogle Scholar
  7. 7.
    Rohrich RJ, Ha RY, Kenkel JM, et al. (2003) Classification and management of gynecomastia: defining the role of ultrasound assisted liposuction. Plast Reconstr Surg 111:909–923PubMedCrossRefGoogle Scholar
  8. 8.
    Wiesman IM, Lehman JA, Parker MG, et al. (2004) Gynecomastia—an outcome analysis. Ann Plast Surg 53:97–101PubMedCrossRefGoogle Scholar
  9. 9.
    Tashkandi M, Al-Qattan MM, Hassanain JM, et al. (2004) The surgical treatment of high-grade gynecomastia. Ann Plast Surg 53:17–20PubMedCrossRefGoogle Scholar
  10. 10.
    Simon BE, Hoffman S, Kahn S (1973) Classification and surgical correction of gynecomastia. Plast Reconstr Surg 51:48–56PubMedCrossRefGoogle Scholar
  11. 11.
    Webster JP (1946) Mastectomy for gynecomastia through a semicircular intra-areolar incision. Ann Surg 124:557PubMedCrossRefGoogle Scholar
  12. 12.
    Benelli L (1990) A new periareolar mammaplasty: the “round block” technique. Aesthetic Plast Surg 14:93–100PubMedCrossRefGoogle Scholar
  13. 13.
    Hodgson ELB, Fruhstorfer BH, Malata CM (2005) Ultrasonic liposuction in the treatment of gynecomastia. Plast Reconstr Surg 116:646–653PubMedCrossRefGoogle Scholar
  14. 14.
    Prado AC, Castillo PF (2005) Minimal surgical access to treat gynecomastia with the use of a power assisted arthroscopic cartilage shaver. Plast Reconstr Surg 115:939–942PubMedCrossRefGoogle Scholar
  15. 15.
    Mentzel T (1998) Hemangioendotheliomas—evolution of a concept of a heterogeneous group of vascular neoplasms (in German). Verh Deutsch Ges Pathol 82:99–111Google Scholar
  16. 16.
    Agoff SN, Lawton TJ (2004) Papillary lesions of the breast with and without atypical ductal hyperplasia: can we accurately predict benign behaviour from core needle biopsy? Am J Clin Pathol 122:440–443PubMedCrossRefGoogle Scholar
  17. 17.
    Prasad V, King JM, McLeay W (2005) Bilateral atypical ductal hyperplasia, an incidental finding in gynecomastia. Breast 14:317–321PubMedCrossRefGoogle Scholar
  18. 18.
    Fentiman IS, Fourquet A, Hortobagyi GN (2006) Male breast cancer. Lancet 367:595–604PubMedCrossRefGoogle Scholar
  19. 19.
    Voulliaume D, Vasseur C, Delaporte T, et al. (2003) An unusual risk of liposuction: liposuction of a malignant tumor (in French). Ann Chir Plast Esthet 48:187–193PubMedCrossRefGoogle Scholar
  20. 20.
    Fodor PB (1989) Breast cancer in a patient with gynecomastia. Plast Reconstr Surg 84:976–979PubMedCrossRefGoogle Scholar
  21. 21.
    DeBree E, Tsagkatakis T, Kafousi M, et al. (2005) Breast enlargement in young men not always gynecomastia. Breast cancer in a 22-year-old man. Aust N Z J Surg 75:914–916CrossRefGoogle Scholar
  22. 22.
    Staerkle RF, Lenzlinger P, Suter SL, et al. (2006) Synchronous bilateral ductal carcinoma in situ of the male breast associated with gynecomastia in a 30-year-old patient following repeated injections of stanozolol. Breast Cancer Res Treat 97:173–176PubMedCrossRefGoogle Scholar
  23. 23.
    Wadie GM, Banever GT, Moriarty KP, et al. (2005) Ductal carcinoma in situ in a 16-year-old adolescent boy with gynecomastia: a case report. J Pediatr Surg 40:1349–1353PubMedCrossRefGoogle Scholar
  24. 24.
    Aslan G, Tuncali D, Terzioglu A, et al. (2005) Periareolar-transareolar-perithelial incision for the surgical treatment of gynecomastia. Ann Plast Surg 54:130–134PubMedCrossRefGoogle Scholar
  25. 25.
    Cooper RA, Gunter BA, Ramamurthy L (1994) Mammography in men. Radiology 191:651–656PubMedGoogle Scholar
  26. 26.
    Caruso G, Ienzi R, Piovana G, et al. (2004) High-frequency ultrasound in the study of male breast palpable masses. Radiol Med (Torino) 108:185–193Google Scholar

Copyright information

© Société Internationale de Chirurgie 2007

Authors and Affiliations

  • A. E. Handschin
    • 1
    Email author
  • D. Bietry
    • 1
  • R. Hüsler
    • 1
  • A. Banic
    • 1
  • M. Constantinescu
    • 1
  1. 1.Department of Plastic and Reconstructive SurgeryUniversity Hospital of BernBerneSwitzerland

Personalised recommendations