A systematic approach to the surgical treatment of gynaecomastia☆
Section snippets
Patients and methods
All patients who were operated on for gynaecomastia by the senior author between September 1999 and November 2001 were included in the study. The grade of gynaecomastia was assessed from the patients' preoperative photographs and case notes. Following surgery, patients were reviewed in the outpatient clinic between September 2001 and January 2002. Patients who had already been discharged from follow-up were invited to attend the outpatient clinic for a further review. The patients were examined
Results
Overall, 29 patients underwent surgery for gynaecomastia over the 27 month period. Their ages ranged from 13 years to 57 years (mean: 25 years), and 19 patients presented with bilateral and 10 patients with unilateral gynaecomastia. In total, 48 breasts were surgically treated. The majority of the breasts treated were assessed as small to moderate (Table 1).
Nearly all the breasts were treated by liposuction, alone or as an adjunct (Table 2). One breast was treated by open excision alone,
Discussion
Surgery is the mainstay of treatment for gynaecomastia. Although a wide range of surgical techniques have been described, surgeons often find it difficult to choose the technique that will achieve the best results for a given patient.
In all patients, liposuction was planned as part of the procedure. The majority of breasts were treated by liposuction only. In 17 breasts, further correction by open excision and/or skin reduction was performed. Conventional liposuction combined with open excision
Acknowledgements
The authors thank Mrs Sue Ramsey, Medical Secretary, for kindly obtaining all the case notes and organising review appointments. Additional thanks to Mr. Phillip Ball, Senior Medical Artist, for the illustrations.
The Authors
Birgit H. Fruhstorfer FRCS, Clinical Fellow in Plastic Surgery
References (32)
- et al.
Correction of extreme gynaecomastia
Br J Plast Surg
(1974) - et al.
Comparing ultrasound-assisted lipoplasty with suction-assisted lipoplasty
Clin Plast Surg
(1999) - et al.
Gynaecomastia in adolescent boys
JAMA
(1961) Gynaecomastia as a physical finding in normal men
J Clin Endocrinol Metab
(1979)- et al.
Gynaecomastia
Br J Surg
(1991) Gynecomastia
N Engl J Med
(1993)- (1847)
Mastectomy for gynaecomastia through a semicircular intra-areolar incision
Ann Surg
(1946)- et al.
Surgical correction of massive gynecomastia
Plast Reconstr Surg
(1972) - et al.
Male reduction mammoplasty in serious gynecomastias
Aesthetic Plast Surg
(1992)
Concentric circle operation for massive gynecomastia to excise the redundant skin
Plast Reconstr Surg
Gynecomastia and the complete circumareolar approach in the surgical management of skin redundancy
Plast Reconstr Surg
A circumareolar approach in surgical management of gynaecomastia
Plast Reconstr Surg
Body contouring by lipolysis: a 5-year experience with over 3000 cases
Plast Reconstr Surg
Ultrasonic liposculpturing
Aesthetic Plast Surg
Gynaecomastia: have Webster's lessons been ignored?
J R Coll Surg Edinb
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The Authors
Birgit H. Fruhstorfer FRCS, Clinical Fellow in Plastic Surgery
Charles M. Malata FRCS(Plast), Consultant Plastic Surgeon
Department of Plastic and Reconstructive Surgery, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, UK
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Presented at the 37th Congress of the European Society for Surgical Research, Szeged, Hungary, 23–25 May 2002, and the Summer Scientific Meeting of British Association of Plastic Surgeons, London, UK, 3–5 July 2002.