Skip to main content
Erschienen in: Aesthetic Plastic Surgery 5/2017

27.04.2017 | Original Article

The Characteristics and Short-Term Surgical Outcomes of Adolescent Gynecomastia

verfasst von: Byung Seo Choi, Sung Ryul Lee, Geon Young Byun, Seong Bae Hwang, Bum Hwan Koo

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 5/2017

Einloggen, um Zugang zu erhalten

Abstract

Background

Most adolescent gynecomastia is resolved spontaneously in 3 years. But, persistent gynecomastia could have a negative influence on psychoemotional development on adolescence. The purpose of this study is to report the characteristics of adolescent gynecomastia patients who received the surgeries, and discuss the short-term surgical outcomes.

Methods

Of the 1454 patients who underwent gynecomastia surgery at Damsoyu hospital from January 2014 to May 2016, 71 were adolescents. Subcutaneous mastectomy with liposuction was performed for adolescent patients who had gynecomastia for more than 3 years and showed psychosocial distress. Demographic and outcome variables were retrospectively analyzed.

Results

The mean age was 17.5 ± 0.77 years old. All gynecomastia cases were bilateral. Simon’s grade IIa (35 patients, 49.3%) was the most common, and grade III was not observed. Fifty-one patients (71.8%) were classified as having a glandular-type breast component. Fourteen patients (19.7%) had complications, but only 3 cases (4.2%) required revision. Most of the patients (70 patients, 98.6%) were satisfied with the esthetic results, and the average 5-point Likert score was 4.85 ± 0.40. Recurrence was not observed. As the Simon’s grade increased from I to IIA, a higher BMI, larger amounts of breast tissue, and longer operation times were observed.

Conclusions

Gynecomastia that did not regress spontaneously was mostly the glandular type, so not only liposuction but also surgical removal of glandular tissue is necessary. Surgical treatment, selectively performed in patients who have had gynecomastia for 3 years, and have experienced psychosocial distress, could be an acceptable treatment for adolescent gynecomastia.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the table of contents or the online instructions to authors www.​springer.​com/​00266.
Literatur
3.
Zurück zum Zitat Kumanov P, Deepinder F, Robeva R, Tomova A, Li J, Agarwal A (2007) Relationship of adolescent gynecomastia with varicocele and somatometric parameters: a cross-sectional study in 6200 healthy boys. J Adolesc Health 41:126–131CrossRefPubMed Kumanov P, Deepinder F, Robeva R, Tomova A, Li J, Agarwal A (2007) Relationship of adolescent gynecomastia with varicocele and somatometric parameters: a cross-sectional study in 6200 healthy boys. J Adolesc Health 41:126–131CrossRefPubMed
4.
Zurück zum Zitat Nydick M, Bustos J, Dale JH Jr, Rawson RW (1961) Gynecomastia in adolescent boys. JAMA 178:449–454CrossRefPubMed Nydick M, Bustos J, Dale JH Jr, Rawson RW (1961) Gynecomastia in adolescent boys. JAMA 178:449–454CrossRefPubMed
5.
Zurück zum Zitat Fischer S, Hirsch T, Hirche C, Kiefer J, Kueckelhaus M, Germann G, Reichenberger MA (2014) Surgical treatment of primary gynecomastia in children and adolescents. Pediatr Surg Int 30:641–647CrossRefPubMed Fischer S, Hirsch T, Hirche C, Kiefer J, Kueckelhaus M, Germann G, Reichenberger MA (2014) Surgical treatment of primary gynecomastia in children and adolescents. Pediatr Surg Int 30:641–647CrossRefPubMed
6.
Zurück zum Zitat Rew L, Young C, Harrison T, Caridi R (2015) A systematic review of literature on psychosocial aspects of gynecomastia in adolescents and young men. J Adolesc 43:206–212CrossRefPubMed Rew L, Young C, Harrison T, Caridi R (2015) A systematic review of literature on psychosocial aspects of gynecomastia in adolescents and young men. J Adolesc 43:206–212CrossRefPubMed
7.
Zurück zum Zitat Davanco RA, Sabino Neto M, Garcia EB, Matsuoka PK, Huijsmans JP, Ferreira LM (2009) Quality of life in the surgical treatment of gynecomastia. Aesthetic Plast Surg 33:514–517CrossRefPubMed Davanco RA, Sabino Neto M, Garcia EB, Matsuoka PK, Huijsmans JP, Ferreira LM (2009) Quality of life in the surgical treatment of gynecomastia. Aesthetic Plast Surg 33:514–517CrossRefPubMed
8.
Zurück zum Zitat Kinsella C Jr, Landfair A, Rottgers SA, Cray JJ, Weidman C, Deleyiannis FW, Grunwaldt L, Losee JE (2012) The psychological burden of idiopathic adolescent gynecomastia. Plast Reconstr Surg 129:1–7CrossRefPubMed Kinsella C Jr, Landfair A, Rottgers SA, Cray JJ, Weidman C, Deleyiannis FW, Grunwaldt L, Losee JE (2012) The psychological burden of idiopathic adolescent gynecomastia. Plast Reconstr Surg 129:1–7CrossRefPubMed
9.
Zurück zum Zitat Kumar S, Kelly AS (2017) Review of childhood obesity: from epidemiology, etiology, and comorbidities to clinical assessment and treatment. Mayo Clin Proc 92:251–265CrossRefPubMed Kumar S, Kelly AS (2017) Review of childhood obesity: from epidemiology, etiology, and comorbidities to clinical assessment and treatment. Mayo Clin Proc 92:251–265CrossRefPubMed
10.
11.
Zurück zum Zitat Ridha H, Colville RJ, Vesely MJ (2009) How happy are patients with their gynaecomastia reduction surgery? J Plast Reconstr Aesthet Surg 62:1473–1478CrossRefPubMed Ridha H, Colville RJ, Vesely MJ (2009) How happy are patients with their gynaecomastia reduction surgery? J Plast Reconstr Aesthet Surg 62:1473–1478CrossRefPubMed
12.
Zurück zum Zitat Lapid O, Jolink F, Meijer SL (2015) Pathological findings in gynecomastia: analysis of 5113 breasts. Ann Plast Surg 74:163–166CrossRefPubMed Lapid O, Jolink F, Meijer SL (2015) Pathological findings in gynecomastia: analysis of 5113 breasts. Ann Plast Surg 74:163–166CrossRefPubMed
13.
Zurück zum Zitat Narula HS, Carlson HE (2014) Gynaecomastia–pathophysiology, diagnosis and treatment. Nat Rev Endocrinol 10:684–698CrossRefPubMed Narula HS, Carlson HE (2014) Gynaecomastia–pathophysiology, diagnosis and treatment. Nat Rev Endocrinol 10:684–698CrossRefPubMed
14.
Zurück zum Zitat Laituri CA, Garey CL, Ostlie DJ, St Peter SD, Gittes GK, Snyder CL (2010) Treatment of adolescent gynecomastia. J Pediatr Surg 45:650–654CrossRefPubMed Laituri CA, Garey CL, Ostlie DJ, St Peter SD, Gittes GK, Snyder CL (2010) Treatment of adolescent gynecomastia. J Pediatr Surg 45:650–654CrossRefPubMed
15.
Zurück zum Zitat Ng AM, Dissanayake D, Metcalf C, Wylie E (2014) Clinical and imaging features of male breast disease, with pathological correlation: a pictorial essay. J Med Imaging Radiat Oncol 58:189–198CrossRefPubMed Ng AM, Dissanayake D, Metcalf C, Wylie E (2014) Clinical and imaging features of male breast disease, with pathological correlation: a pictorial essay. J Med Imaging Radiat Oncol 58:189–198CrossRefPubMed
16.
Zurück zum Zitat Wigley KD, Thomas JL, Bernardino ME, Rosenbaum JL (1981) Sonography of gynecomastia. AJR Am J Roentgenol 136:927–930CrossRefPubMed Wigley KD, Thomas JL, Bernardino ME, Rosenbaum JL (1981) Sonography of gynecomastia. AJR Am J Roentgenol 136:927–930CrossRefPubMed
18.
Zurück zum Zitat Rahmani S, Turton P, Shaaban A, Dall B (2011) Overview of gynecomastia in the modern era and the leeds gynaecomastia investigation algorithm. Breast J 17:246–255CrossRefPubMed Rahmani S, Turton P, Shaaban A, Dall B (2011) Overview of gynecomastia in the modern era and the leeds gynaecomastia investigation algorithm. Breast J 17:246–255CrossRefPubMed
19.
Zurück zum Zitat Wiesman IM, Lehman JA, Parker MG, Tantri MD, Wagner DS, Pedersen JC (2004) Gynecomastia: an outcome analysis. Ann Plast Surg 53:97–101CrossRefPubMed Wiesman IM, Lehman JA, Parker MG, Tantri MD, Wagner DS, Pedersen JC (2004) Gynecomastia: an outcome analysis. Ann Plast Surg 53:97–101CrossRefPubMed
21.
Zurück zum Zitat Kim DH, Byun IH, Lee WJ, Rah DK, Kim JY, Lee DW (2016) Surgical management of gynecomastia: subcutaneous mastectomy and liposuction. Aesthet Plast Surg 40:877–884CrossRef Kim DH, Byun IH, Lee WJ, Rah DK, Kim JY, Lee DW (2016) Surgical management of gynecomastia: subcutaneous mastectomy and liposuction. Aesthet Plast Surg 40:877–884CrossRef
22.
Zurück zum Zitat Fagerlund A, Lewin R, Rufolo G, Elander A, Santanelli di Pompeo F, Selvaggi G (2015) Gynecomastia: a systematic review. J Plast Surg Hand Surg 49:311–318CrossRefPubMed Fagerlund A, Lewin R, Rufolo G, Elander A, Santanelli di Pompeo F, Selvaggi G (2015) Gynecomastia: a systematic review. J Plast Surg Hand Surg 49:311–318CrossRefPubMed
23.
Zurück zum Zitat Cordova A, Moschella F (2008) Algorithm for clinical evaluation and surgical treatment of gynaecomastia. J Plast Reconstr Aesthet Surg 61:41–49CrossRefPubMed Cordova A, Moschella F (2008) Algorithm for clinical evaluation and surgical treatment of gynaecomastia. J Plast Reconstr Aesthet Surg 61:41–49CrossRefPubMed
24.
Zurück zum Zitat Niewoehner CB, Nuttal FQ (1984) Gynecomastia in a hospitalized male population. Am J Med 77:633–638CrossRefPubMed Niewoehner CB, Nuttal FQ (1984) Gynecomastia in a hospitalized male population. Am J Med 77:633–638CrossRefPubMed
25.
Zurück zum Zitat Einav-Bachar R, Phillip M, Aurbach-Klipper Y, Lazar L (2004) Prepubertal gynaecomastia: aetiology, course and outcome. Clin Endocrinol (Oxf) 61:55–60CrossRef Einav-Bachar R, Phillip M, Aurbach-Klipper Y, Lazar L (2004) Prepubertal gynaecomastia: aetiology, course and outcome. Clin Endocrinol (Oxf) 61:55–60CrossRef
26.
Zurück zum Zitat 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
27.
Zurück zum Zitat Handschin AE, Bietry D, Husler R, Banic A, Constantinescu M (2008) Surgical management of gynecomastia—a 10-year analysis. World J Surg 32:38–44CrossRefPubMed Handschin AE, Bietry D, Husler R, Banic A, Constantinescu M (2008) Surgical management of gynecomastia—a 10-year analysis. World J Surg 32:38–44CrossRefPubMed
28.
Zurück zum Zitat Ebner FK, Friedl TW, Degregorio N, Reich A, Janni W, Rempen A (2013) Does non-placement of a drain in breast surgery increase the rate of complications and revisions? Geburtshilfe Frauenheilkd 73:1128–1134CrossRefPubMedPubMedCentral Ebner FK, Friedl TW, Degregorio N, Reich A, Janni W, Rempen A (2013) Does non-placement of a drain in breast surgery increase the rate of complications and revisions? Geburtshilfe Frauenheilkd 73:1128–1134CrossRefPubMedPubMedCentral
29.
Zurück zum Zitat Taylor JC, Rai S, Hoar F, Brown H, Vishwanath L (2013) Breast cancer surgery without suction drainage: the impact of adopting a ‘no drains’ policy on symptomatic seroma formation rates. Eur J Surg Oncol 39:334–338CrossRefPubMed Taylor JC, Rai S, Hoar F, Brown H, Vishwanath L (2013) Breast cancer surgery without suction drainage: the impact of adopting a ‘no drains’ policy on symptomatic seroma formation rates. Eur J Surg Oncol 39:334–338CrossRefPubMed
30.
Zurück zum Zitat Innocenti A, Melita D, Mori F, Ciancio F, Innocenti M (2017) Management of gynecomastia in patients with different body types: considerations on 312 consecutive treated cases. Ann Plast Surg 78(5):492–496CrossRefPubMed Innocenti A, Melita D, Mori F, Ciancio F, Innocenti M (2017) Management of gynecomastia in patients with different body types: considerations on 312 consecutive treated cases. Ann Plast Surg 78(5):492–496CrossRefPubMed
Metadaten
Titel
The Characteristics and Short-Term Surgical Outcomes of Adolescent Gynecomastia
verfasst von
Byung Seo Choi
Sung Ryul Lee
Geon Young Byun
Seong Bae Hwang
Bum Hwan Koo
Publikationsdatum
27.04.2017
Verlag
Springer US
Erschienen in
Aesthetic Plastic Surgery / Ausgabe 5/2017
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-017-0886-z

Weitere Artikel der Ausgabe 5/2017

Aesthetic Plastic Surgery 5/2017 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.