Skip to main content

Advertisement

Log in

Surgical Management of Gynecomastia—a 10-year Analysis

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

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.

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

Access this article

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
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Braunstein GD (1993) Gynecomastia. N Engl J Med 328:490–495

    Article  PubMed  CAS  Google Scholar 

  2. Gabra HO, Morabito A, Bianchi A, et al. (2004) Gynecomastia in the adolescent; a surgically relevant condition. Eur J Pediatr Surg 14:3–6

    Article  PubMed  CAS  Google Scholar 

  3. Colombo-Benkmann M, Buse B, Stern J, et al. (1999) Indications for and results of surgical therapy for male gynecomastia. Am J Surg 178:60–63

    Article  PubMed  CAS  Google Scholar 

  4. Steele SR, Martin MJ, Place RJ (2002) Gynecomastia: complications of the subcutaneous mastectomy. Am Surg 68:210–213

    PubMed  Google Scholar 

  5. Boljanovic S, Axelsson CK, Elberg JJ (2003) Surgical treatment of gynecomastia: liposuction combined with subcutaneous mastectomy. Scand J Surg 92:160–162

    PubMed  CAS  Google Scholar 

  6. Fruhstorfer BH, Malata CM (2003) A systematic approach to the surgical treatment of gynecomastia. Br J Plast Surg 56:237–246

    Article  PubMed  CAS  Google Scholar 

  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 111:909–923

    Article  PubMed  Google Scholar 

  8. Wiesman IM, Lehman JA, Parker MG, et al. (2004) Gynecomastia—an outcome analysis. Ann Plast Surg 53:97–101

    Article  PubMed  Google Scholar 

  9. Tashkandi M, Al-Qattan MM, Hassanain JM, et al. (2004) The surgical treatment of high-grade gynecomastia. Ann Plast Surg 53:17–20

    Article  PubMed  Google Scholar 

  10. Simon BE, Hoffman S, Kahn S (1973) Classification and surgical correction of gynecomastia. Plast Reconstr Surg 51:48–56

    Article  PubMed  CAS  Google Scholar 

  11. Webster JP (1946) Mastectomy for gynecomastia through a semicircular intra-areolar incision. Ann Surg 124:557

    Article  PubMed  CAS  Google Scholar 

  12. Benelli L (1990) A new periareolar mammaplasty: the “round block” technique. Aesthetic Plast Surg 14:93–100

    Article  PubMed  CAS  Google Scholar 

  13. Hodgson ELB, Fruhstorfer BH, Malata CM (2005) Ultrasonic liposuction in the treatment of gynecomastia. Plast Reconstr Surg 116:646–653

    Article  PubMed  CAS  Google Scholar 

  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 115:939–942

    Article  PubMed  CAS  Google Scholar 

  15. Mentzel T (1998) Hemangioendotheliomas—evolution of a concept of a heterogeneous group of vascular neoplasms (in German). Verh Deutsch Ges Pathol 82:99–111

    CAS  Google Scholar 

  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 122:440–443

    Article  PubMed  Google Scholar 

  17. Prasad V, King JM, McLeay W (2005) Bilateral atypical ductal hyperplasia, an incidental finding in gynecomastia. Breast 14:317–321

    Article  PubMed  Google Scholar 

  18. Fentiman IS, Fourquet A, Hortobagyi GN (2006) Male breast cancer. Lancet 367:595–604

    Article  PubMed  Google Scholar 

  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 48:187–193

    Article  PubMed  CAS  Google Scholar 

  20. Fodor PB (1989) Breast cancer in a patient with gynecomastia. Plast Reconstr Surg 84:976–979

    Article  PubMed  CAS  Google Scholar 

  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 75:914–916

    Article  Google Scholar 

  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 97:173–176

    Article  PubMed  Google Scholar 

  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 40:1349–1353

    Article  PubMed  Google Scholar 

  24. Aslan G, Tuncali D, Terzioglu A, et al. (2005) Periareolar-transareolar-perithelial incision for the surgical treatment of gynecomastia. Ann Plast Surg 54:130–134

    Article  PubMed  CAS  Google Scholar 

  25. Cooper RA, Gunter BA, Ramamurthy L (1994) Mammography in men. Radiology 191:651–656

    PubMed  CAS  Google Scholar 

  26. Caruso G, Ienzi R, Piovana G, et al. (2004) High-frequency ultrasound in the study of male breast palpable masses. Radiol Med (Torino) 108:185–193

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. E. Handschin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Handschin, A.E., Bietry, D., Hüsler, R. et al. Surgical Management of Gynecomastia—a 10-year Analysis. World J Surg 32, 38–44 (2008). https://doi.org/10.1007/s00268-007-9280-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-007-9280-3

Keywords

Navigation