ABSTRACT
Introduction: Gynaecomastia is a common problem in the male population with a reported prevalence
of up to 36%. Various treatment techniques have been described but none have gained
universal acceptance. We reviewed all gynaecomastia patients operated on by one consultant
over a 7-year period to assess the morbidity and complication rates associated with
the procedure. Materials and Methods: Clinical notes and outpatient records of all patients who underwent gynaecomastia
correction at University Hospital North Staffordshire between 01/10/2001 to 01/10/2009
were retrospectively reviewed. A modified version of the Breast Evaluation Questionnaire
was used to assess patients satisfaction with the procedure. Results: Twenty-nine patients and a total of 53 breasts were operated on during the study
period. Patients underwent either liposuction alone (6 breasts - 11.3%), excision
alone (37 breasts - 69.8%) or both excision and liposuction (10 breasts - 18.9%).
Twelve operated breasts (22.6%) experienced some form of complication. Minor complications
included seroma (2 patients), superficial wound dehiscence (2 patients) and minor
bleeding not requiring theatre (3 patients). Two patients developed haematomas requiring
evacuation in theatre. No cases of wound infection, major wound dehiscence or revision
surgery were encountered. Twenty-six patients (89.7%) returned the patient satisfaction
questionnaire. Patients scored an average 4.12 with regards comfort of their chest
in different settings, 3.98 with regards chest appearance in different settings, and
4.22 with regards satisfaction levels for themselves and their partner/family. Overall
complication rate was 22.6%. Grade III patients experienced the highest complication
rate (35.7%), followed by grade II (22.7%) and grade I (17.6%). Overall complication
rates among the excision only group was the highest (29.8%) followed by the liposuction
only group (16.7%) and the liposuction and excision group (10.0%). There were high
satisfaction rates amongst both patients and surgeon. Eleven patients (37.9%) had
their outcome classified as ‘excellent’ by the operating surgeon, 16 patients (55.2%)
as ‘good’, 1 (3.4%) as ‘satisfactory’ and 1(3.4%) as ‘poor’. Conclusion: Gynaecomastia is a complex condition which poses a significant challenge to the plastic
surgeon. Despite the possible complications our case series demonstrates that outcomes
of operative correction can be favourable and yield high levels of satisfaction from
both patient and surgeon.
KEY WORDS
Plastic Surgery - University Hospital North Staffordshire - Correction - gynaecomastia
- surgery
