The body habitus, age and expectations of men presenting with gynaecomastia are changing. Formerly, gynaecomastia presented mainly as a problem of post-pubertal males with incomplete resolution of physiological gynaecomastia. Now adults in their second to fourth decades present with breast enlargement from iatrogenic drug use, obesity, or with skin and fat excess following massive weight loss (pseudo-gynaecomastia). Adolescents present with obesity. By considering each enlarged component and addressing each in turn, it should be possible to reduce the breast to normal dimensions and form—the end point of this surgery being a masculine appearance. This article presents four patients with gynaecomastia but with widely varying body habitus. Surgical treatment for gynaecomastia involves the application of liposuction and/or open reduction. Two features are added to this standard surgical management to try and optimize surgical outcome: staged serial excision to minimise scars and the use of a preoperative checklist to establish realistic goals.
European Journal of Plastic Surgery – Springer Journals
Published: Jan 1, 2012
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