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Gynecomastia Revisited: A Demographic Overview And Surgical Algorithm For Care
Johnson CA, Lee JA, Grunwaldt LJ.
University of Pittsburgh Medical Center, Department of Plastic Surgery
2017-01-26
Presenter: Chelsey A Johnson
Affidavit:
Chelsey Johnson
Director Name: Dr. Vu Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background: Gynecomastia in the adolescent population is common, with an incidence up to 69%. The psychological impact it causes is well documented and published. The surgical approach to care, however, is not standardized.
Methods: A retrospective chart review was performed of all patients with gynecomastia cared for by a single surgeon between 2010 – 2016. Demographics were analyzed and the operative technique and outcomes were assessed.
Results: 32 patients (61 breasts) were reviewed. All patients had a subcutaneous mastectomy via a periareolar technique. In 13 patients, liposuction was added to the procedure. 29 patients had bilateral surgery and 3 patients had unilateral surgery. Average age of surgery was 15.5 years and the average BMI was 26. The average amount of tissue removed on a side was 52g. 3 patients had a secondary surgery to remove excess skin and an additional patient underwent a revision mastectomy, yielding a revision rate of 12.5%. Patients who required a second surgery had a higher BMI and larger initial resection compared to those who did not, although not statistically significant. 1 patient had a complication resulting in take back for a hematoma (3%).
Conclusion: Gynecomastia is prevalent and often requires surgical intervention despite the often small amount of tissue that causes the deformity. Utilization of a minimally invasive technique without skin resection leads to ideal aesthetic outcome with negligible scarring and a low revision rate. This study reveals the ability to achieve successful and reproducible outcomes via the same approach for all grades of gynecomastia.
