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Semin Plast Surg 2015; 29(02): 122-130
DOI: 10.1055/s-0035-1549053
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Trends in the Surgical Correction of Gynecomastia

Rodger H. Brown
1   Division of Plastic and Reconstructive Surgery, Baylor College of Medicine, Houston, Texas
,
Daniel K. Chang
1   Division of Plastic and Reconstructive Surgery, Baylor College of Medicine, Houston, Texas
,
Richard Siy
1   Division of Plastic and Reconstructive Surgery, Baylor College of Medicine, Houston, Texas
,
Jeffrey Friedman
2   Division of Plastic Surgery, and Plastic and Reconstructive Surgery, The Methodist Hospital, Houston, Texas
› Author Affiliations
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Publication History

Publication Date:
16 April 2015 (online)

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Abstract

Gynecomastia refers to the enlargement of the male breast due to a proliferation of ductal, stromal, and/or fatty tissue. Although it is a common condition affecting up to 65% of men, not all cases require surgical intervention. Contemporary surgical techniques in the treatment of gynecomastia have become increasingly less invasive with the advent of liposuction and its variants, including power-assisted and ultrasound-assisted liposuction. These techniques, however, have been largely limited in their inability to address significant skin excess and ptosis. For mild to moderate gynecomastia, newer techniques using arthroscopic morcellation and endoscopic techniques promise to address the fibrous component, while minimizing scar burden by utilizing liposuction incisions. Nevertheless, direct excision through periareolar incisions remains a mainstay in treatment algorithms for its simplicity and avoidance of additional instrumentation. This is particularly true for more severe cases of gynecomastia requiring skin resection. In the most severe cases with significant skin redundancy and ptosis, breast amputation with free nipple grafting remains an effective option. Surgical treatment should be individualized to each patient, combining techniques to provide adequate resection and optimize aesthetic results.

Keywords

gynecomastia - surgical treatment of gynecomastia - gynecomastia review - gynecomastia techniques
 

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