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Published in: World Journal of Surgery 1/2008

01-01-2008

Surgical Management of Gynecomastia—a 10-year Analysis

Authors: A. E. Handschin, D. Bietry, R. Hüsler, A. Banic, M. Constantinescu

Published in: World Journal of Surgery | Issue 1/2008

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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.
Literature
2.
go back to reference Gabra HO, Morabito A, Bianchi A, et al. (2004) Gynecomastia in the adolescent; a surgically relevant condition. Eur J Pediatr Surg 14:3–6PubMedCrossRef Gabra HO, Morabito A, Bianchi A, et al. (2004) Gynecomastia in the adolescent; a surgically relevant condition. Eur J Pediatr Surg 14:3–6PubMedCrossRef
3.
go back to reference Colombo-Benkmann M, Buse B, Stern J, et al. (1999) Indications for and results of surgical therapy for male gynecomastia. Am J Surg 178:60–63PubMedCrossRef Colombo-Benkmann M, Buse B, Stern J, et al. (1999) Indications for and results of surgical therapy for male gynecomastia. Am J Surg 178:60–63PubMedCrossRef
4.
go back to reference Steele SR, Martin MJ, Place RJ (2002) Gynecomastia: complications of the subcutaneous mastectomy. Am Surg 68:210–213PubMed Steele SR, Martin MJ, Place RJ (2002) Gynecomastia: complications of the subcutaneous mastectomy. Am Surg 68:210–213PubMed
5.
go back to reference Boljanovic S, Axelsson CK, Elberg JJ (2003) Surgical treatment of gynecomastia: liposuction combined with subcutaneous mastectomy. Scand J Surg 92:160–162PubMed Boljanovic S, Axelsson CK, Elberg JJ (2003) Surgical treatment of gynecomastia: liposuction combined with subcutaneous mastectomy. Scand J Surg 92:160–162PubMed
6.
go back to reference Fruhstorfer BH, Malata CM (2003) A systematic approach to the surgical treatment of gynecomastia. Br J Plast Surg 56:237–246PubMedCrossRef Fruhstorfer BH, Malata CM (2003) A systematic approach to the surgical treatment of gynecomastia. Br J Plast Surg 56:237–246PubMedCrossRef
7.
go back to reference Rohrich RJ, Ha RY, Kenkel JM, et al. (2003) Classification and management of gynecomastia: defining the role of ultrasound assisted liposuction. Plast Reconstr Surg 111:909–923PubMedCrossRef Rohrich RJ, Ha RY, Kenkel JM, et al. (2003) Classification and management of gynecomastia: defining the role of ultrasound assisted liposuction. Plast Reconstr Surg 111:909–923PubMedCrossRef
8.
go back to reference Wiesman IM, Lehman JA, Parker MG, et al. (2004) Gynecomastia—an outcome analysis. Ann Plast Surg 53:97–101PubMedCrossRef Wiesman IM, Lehman JA, Parker MG, et al. (2004) Gynecomastia—an outcome analysis. Ann Plast Surg 53:97–101PubMedCrossRef
9.
go back to reference Tashkandi M, Al-Qattan MM, Hassanain JM, et al. (2004) The surgical treatment of high-grade gynecomastia. Ann Plast Surg 53:17–20PubMedCrossRef Tashkandi M, Al-Qattan MM, Hassanain JM, et al. (2004) The surgical treatment of high-grade gynecomastia. Ann Plast Surg 53:17–20PubMedCrossRef
10.
go back to reference Simon BE, Hoffman S, Kahn S (1973) Classification and surgical correction of gynecomastia. Plast Reconstr Surg 51:48–56PubMedCrossRef Simon BE, Hoffman S, Kahn S (1973) Classification and surgical correction of gynecomastia. Plast Reconstr Surg 51:48–56PubMedCrossRef
11.
go back to reference Webster JP (1946) Mastectomy for gynecomastia through a semicircular intra-areolar incision. Ann Surg 124:557PubMedCrossRef Webster JP (1946) Mastectomy for gynecomastia through a semicircular intra-areolar incision. Ann Surg 124:557PubMedCrossRef
12.
go back to reference Benelli L (1990) A new periareolar mammaplasty: the “round block” technique. Aesthetic Plast Surg 14:93–100PubMedCrossRef Benelli L (1990) A new periareolar mammaplasty: the “round block” technique. Aesthetic Plast Surg 14:93–100PubMedCrossRef
13.
go back to reference Hodgson ELB, Fruhstorfer BH, Malata CM (2005) Ultrasonic liposuction in the treatment of gynecomastia. Plast Reconstr Surg 116:646–653PubMedCrossRef Hodgson ELB, Fruhstorfer BH, Malata CM (2005) Ultrasonic liposuction in the treatment of gynecomastia. Plast Reconstr Surg 116:646–653PubMedCrossRef
14.
go back to reference Prado AC, Castillo PF (2005) Minimal surgical access to treat gynecomastia with the use of a power assisted arthroscopic cartilage shaver. Plast Reconstr Surg 115:939–942PubMedCrossRef Prado AC, Castillo PF (2005) Minimal surgical access to treat gynecomastia with the use of a power assisted arthroscopic cartilage shaver. Plast Reconstr Surg 115:939–942PubMedCrossRef
15.
go back to reference Mentzel T (1998) Hemangioendotheliomas—evolution of a concept of a heterogeneous group of vascular neoplasms (in German). Verh Deutsch Ges Pathol 82:99–111 Mentzel T (1998) Hemangioendotheliomas—evolution of a concept of a heterogeneous group of vascular neoplasms (in German). Verh Deutsch Ges Pathol 82:99–111
16.
go back to reference 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 122:440–443PubMedCrossRef 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 122:440–443PubMedCrossRef
17.
go back to reference Prasad V, King JM, McLeay W (2005) Bilateral atypical ductal hyperplasia, an incidental finding in gynecomastia. Breast 14:317–321PubMedCrossRef Prasad V, King JM, McLeay W (2005) Bilateral atypical ductal hyperplasia, an incidental finding in gynecomastia. Breast 14:317–321PubMedCrossRef
19.
go back to reference 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 48:187–193PubMedCrossRef 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 48:187–193PubMedCrossRef
20.
21.
go back to reference 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 75:914–916CrossRef 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 75:914–916CrossRef
22.
go back to reference 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 97:173–176PubMedCrossRef 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 97:173–176PubMedCrossRef
23.
go back to reference 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 40:1349–1353PubMedCrossRef 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 40:1349–1353PubMedCrossRef
24.
go back to reference Aslan G, Tuncali D, Terzioglu A, et al. (2005) Periareolar-transareolar-perithelial incision for the surgical treatment of gynecomastia. Ann Plast Surg 54:130–134PubMedCrossRef Aslan G, Tuncali D, Terzioglu A, et al. (2005) Periareolar-transareolar-perithelial incision for the surgical treatment of gynecomastia. Ann Plast Surg 54:130–134PubMedCrossRef
25.
go back to reference Cooper RA, Gunter BA, Ramamurthy L (1994) Mammography in men. Radiology 191:651–656PubMed Cooper RA, Gunter BA, Ramamurthy L (1994) Mammography in men. Radiology 191:651–656PubMed
26.
go back to reference 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 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
Metadata
Title
Surgical Management of Gynecomastia—a 10-year Analysis
Authors
A. E. Handschin
D. Bietry
R. Hüsler
A. Banic
M. Constantinescu
Publication date
01-01-2008
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 1/2008
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-007-9280-3

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