Skip to main content

Advertisement

Log in

Infra-areolar subcutaneous mastectomy in the surgical treatment of adolescent gynecomastia

  • Original Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Background

Despite being a common condition in puberty, only 5–10% of pubertal gynecomastia need surgical treatment. Here the authors present their experiences with infra-areolar subcutaneous mastectomy in the surgical treatment of adolescent gynecomastia.

Methods

The records of patients who underwent infra-areolar subcutaneous mastectomy for adolescent gynecomastia between January 2004 and December 2021 were reviewed retrospectively. The patients' demographic data, complaints and clinical presentation, physical examination, laboratory and radiological findings, surgical management, and postoperative follow-ups were evaluated. The patients were evaluated according to the localization of the gynecomastia (unilateral/bilateral) and according to the patients’ body mass index (BMI) (normal/overweight).

Results

A total of 21 boys with a mean age of 15 ± 1.4 years were operated by the senior author and infra-areolar subcutaneous mastectomy by a semilunar incision was performed for adolescent gynecomastia. The mean duration of the complaint was 24.2 ± 10.9 months. Gynecomastia was bilateral in 15 (71.5%) and unilateral in 6 (28.5%) of the patients. Sixteen patients (76.2%) were normal weight, 5 (23.8%) were overweight. Chromosomal anomaly and hypogonadism were detected in two patients. Pseudoangiomatous stromal hyperplasia was detected in the pathology of one patient. The mean follow-up time was 2.7 ± 1 years, seroma developed in 2 patients at the early postoperative period. Their long-term follow-up was uneventful without complication.

Conclusions

The results of infra-areolar subcutaneous mastectomy are very promising in pubertal gynecomastia due to good skin elasticity and without obesity in the adolescent age group. We believe that this method provides an almost invisible incision and a natural pectoral appearance for adolescent patients who have experienced serious emotional problems related to their body images.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4 

Similar content being viewed by others

Data availability

No datasets were generated or analysed during the current study.

References

  1. Soliman AT, De Sanctis V, Yassin M (2017) Management of adolescent gynecomastia: an update. Acta Biomed 88(2):204–213. https://doi.org/10.23750/abm.v88i2.6665

    Article  CAS  PubMed  Google Scholar 

  2. Kim DH, Byun IH, Lee WJ, Rah DK, Kim JY, Lee DW (2016) Surgical management of gynecomastia: subcutaneous mastectomy and liposuction. Aesthetic Plast Surg 40(6):877–884. https://doi.org/10.1007/s00266-016-0705-y

    Article  PubMed  Google Scholar 

  3. Ma NS, Geffner ME (2008) Gynecomastia in prepubertal and pubertal men. Curr Opin Pediatr 20(4):465–470. https://doi.org/10.1097/MOP.0b013e328305e415

    Article  PubMed  Google Scholar 

  4. Uysal Ramadan S, Gökharman D, Kaçar M, Koşar P, Koşar U (2010) Assessment of vascularity with color Doppler ultrasound in gynecomastia. Diagn Interv Radiol 16(1):38–44. https://doi.org/10.4261/1305-3825.DIR.2395-08.1

    Article  Google Scholar 

  5. Kasielska-Trojan A, Antoszewski B (2017) Gynecomastia surgery-impact on life quality: a prospective case-control study. Ann Plast Surg 78(3):264–268. https://doi.org/10.1097/SAP.0000000000000860

    Article  CAS  PubMed  Google Scholar 

  6. Joodaki H, Panzer MB (2018) Skin mechanical properties and modeling: a review. Proc Inst Mech Eng H 232(4):323–343. https://doi.org/10.1177/0954411918759801

    Article  PubMed  Google Scholar 

  7. Rohrich RJ, Ha RY, Kenkel JM, Adams WP Jr (2003) Classification and management of gynecomastia defining the role of ultrasound-assisted liposuction. Plast Reconstr Surg 111(2):909–923. https://doi.org/10.1097/01.PRS.0000042146.40379.25

    Article  PubMed  Google Scholar 

  8. Johnson RE, Murad MH (2009) Gynecomastia: pathophysiology, evaluation, and management. Mayo Clin Proc 84(11):1010–1015. https://doi.org/10.1016/S0025-6196(11)60671-X

    Article  PubMed  PubMed Central  Google Scholar 

  9. Yazici M, Sahin M, Bolu E, Gok DE, Taslipinar A, Tapan S, Torun D, Uckaya G, Kutlu M (2010) Evaluation of breast enlargement in young males and factors associated with gynecomastia and pseudogynecomastia. Ir J Med Sci 179(4):575–583. https://doi.org/10.1007/s11845-009-0345-1

    Article  CAS  PubMed  Google Scholar 

  10. Hoyos AE, Perez ME, Domínguez-Millán R (2021) Gynecomastia treatment through open resection and pectoral high-definition liposculpture. Plast Reconstr Surg 147(5):1072–1083. https://doi.org/10.1097/PRS.0000000000007901

    Article  CAS  PubMed  Google Scholar 

  11. Wells JM, Liu Y, Ginter PS, Nguyen MT, Shin SJ (2015) Elucidating encounters of atypical ductal hyperplasia arising in gynaecomastia. Histopathology 66(3):398–408. https://doi.org/10.1111/his.12545

    Article  PubMed  Google Scholar 

  12. Shehata BM, Fishman I, Collings MH, Wang J, Poulik JM, Ricketts RR et al (2009) Pseudoangiomatous stromal hyperplasia of the breast in pediatric patients: an underrecognized entity. Pediatr Dev Pathol 12(6):450–454. https://doi.org/10.2350/08-09-0528.1

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

Study conception and design: Özlem Balcı, Ayşe Karaman Data acquisition: Ayşe Karaman Analysis and data interpretation: Ayşe Karaman, Özlem Balcı Drafting of the manuscript: Özlem Balcı, Ayşe Karaman, İbrahim Karaman Critical revision: Ayşe Karaman, İbrahim Karaman.

Corresponding author

Correspondence to Özlem Balcı.

Ethics declarations

Conflict of interest

The authors declare that there is no conflict of interest regarding the publication of this article.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Balcı, Ö., Karaman, İ. & Karaman, A. Infra-areolar subcutaneous mastectomy in the surgical treatment of adolescent gynecomastia. Pediatr Surg Int 40, 92 (2024). https://doi.org/10.1007/s00383-024-05671-7

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00383-024-05671-7

Keywords

Navigation