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2017 ; 78
(5
): 492-496
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Management of Gynecomastia in Patients With Different Body Types: Considerations
on 312 Consecutive Treated Cases
#MMPMID27805927
Innocenti A
; Melita D
; Mori F
; Ciancio F
; Innocenti M
Ann Plast Surg
2017[May]; 78
(5
): 492-496
PMID27805927
show ga
BACKGROUND: Gynecomastia is a common finding in male subjects which incidence
varies widely in the world population. In adolescents, it is frequently temporary
but, if it becomes persistent, it generates considerable embarrassment, inducing
the patients to seek surgical consultation. Even in patients with good body
contour, gynecomastia creates even greater distress considering the special
attention given by these subjects to their physical appearance. The authors
present their experience in the treatment of gynecomastia comparing different
body types of patients with the aim to investigate dissimilar expectations, needs
and surgical outcomes thus optimizing the management of the pathological
condition, achieving high levels of agreement and reducing unsatisfied patients
arising from cosmetic surgery. MATERIALS AND METHODS: Between January 2007 and
January 2015, 312 selected patients have been treated surgically for
gynecomastia. Patients were grouped according to their physical aspect: 97 were
classified as high muscle mass body type (group A), 106 as normal (group B) and
109 as overweight patients (group C). All of them were adults ranging in age
between 18 and 52 years. Follow-up ranged from 12 to 60 months. In all cases, an
excision of the gland in the form of a subcutaneous mastectomy was performed; the
most common surgical access was in the inferior part of the areola. RESULTS: No
breast cancers were found at the histological examinations. Also, no skin or
areola necrosis have been referred, and no recurrence of gynecomastia disorder
has been reported. Six cases of seroma (limited to the fatty gynecomastia) and 3
cases of hematomas (requiring immediate surgical revision) were found. Although
the patients in group B resulted more distressed by the disorder, higher levels
of postoperative satisfaction were recorded in this group. CONCLUSIONS: The study
demonstrates the importance of the different management of the same disorder
according to the different patients' expectations, related to the different body
type. Our experience demonstrated that most of the cases did not require
extensive skin incisions, reducing the risk of unpleasant scars and that direct
excision of glandular tissue ensures stable and satisfactory results.