https://doi.org/10.4081/pmc.2024.336
Satisfaction and results of the subareolar incision as treatment for gynecomastia in adolescents: experience of two centers
Submitted: 19 March 2024
Accepted: 23 July 2024
Published: 4 September 2024
Accepted: 23 July 2024
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Gynecomastia is a benign glandular proliferation that can affect adolescents causing significant psychological discomfort. Generally, it is idiopathic but underlying endocrinological conditions must be excluded. Different surgical techniques are available, the surgical correction with subareolar incision achieves the goal of satisfactory aesthetic result for patients. We studied all patients treated for gynecomastia in two centers of pediatric surgery. After collection of a detailed family history, we evaluated the presence of early onset of puberty, congenital abnormalities of the external genitalia, use of drugs, eating habits and the presence of genetic disorders. Laboratory tests and ultrasound were made to exclude endocrinological disorders. The surgical treatment was performed by a subareolar incision with gland and adipose tissue excision. A Body - Q chest module to evaluate patient satisfaction has been proposed to everyone before and after surgery. 47 adolescents with median age of 15 years were surgically treated. Three presented endocrinological disorders. Grade of gynecomastia for surgery was: III in 40 patients and IIb in 7 patients. Postoperative complications occurred in 5 patients. The Body - Q chest module was completed by 42 patients and showed good results for all points analyzed, except for social feelings. Gynecomastia in adolescents can be surgically treated with subareolar incision, reporting good aesthetic results and low incidence of complications. Specific tests are useful to assess patient satisfaction.
Cuhaci N, Polat SB, Evranos B, et al. Gynecomastia: Clinical evaluation and management. Indian J Endocrinol Metab 2014;18:150–8.
DOI: https://doi.org/10.4103/2230-8210.129104
Simon BE, Hoffman S, Kahn S. Classification and surgical correction of gynecomastia. Plast Reconstr Surg 1973;51:48–52.
DOI: https://doi.org/10.1097/00006534-197301000-00009
Kanakis GA, Nordkap L, Bang AK, et al. EAA clinical practice guidelines-gynecomastia evaluation and management. Andrology 2019;7:778-93.
DOI: https://doi.org/10.1111/andr.12636
Soliman AT, De Sanctis V, Yassin M. Management of adolescent gynecomastia: an update. Acta Biomed 2017;88:204-13.
Webster JP. Mastectomy for gynecomastia through a semicircular intra-areolar incision. Ann Surg 1946;124:557–75.
DOI: https://doi.org/10.1097/00000658-194609000-00011
Lista F, Ahmad J. Power-assisted liposuction and the pull through technique for the treatment of gynecomastia. Plast Reconstr Surg 2008;121:740-7.
DOI: https://doi.org/10.1097/01.prs.0000299907.04502.2f
Klassen AF, Kaur M, Poulsen L, etval. Development of the BODY-Q chest module evaluating outcomes following chest contouring surgery. Plast Reconstr Surg 2018;142:1600-8.
DOI: https://doi.org/10.1097/PRS.0000000000004978
Rose G. Gynecomastia. In: Thaller S, Panthaki ZJ. editors. Aesthetic and reconstructive breast surgery solving complications and avoiding unfavorable results. Informa Healthcare; 2012. p. 190–6.
DOI: https://doi.org/10.3109/9781841848488.017
Bannayan G A, Hajdu S I. Gynecomastia: clinicopathologic study of 351 cases. Am J Clin Pathol 1972;57:431-7.
DOI: https://doi.org/10.1093/ajcp/57.4.431
Innocenti A, Melita D, Dreassi E. Incidence of complications for different approaches in gynecomastia correction: a systematic review of the literature. Aesthetic Plast Surg 2022;46:1025-41.
DOI: https://doi.org/10.1007/s00266-022-02782-1
Lee SW, Kwak DS, Jung IS, et al. Partial androgen insensitivity syndrome presenting with gynecomastia. Endocrinol Metab (Seoul) 2015;30:226-30.
DOI: https://doi.org/10.3803/EnM.2015.30.2.226
Vaidyanathan P, Kaplowitz P. Partial androgen insensitivity syndrome presenting as pubertal gynecomastia: clinical and hormonal findings and a novel mutation in the androgen receptor gene. Endocrinol Diabetes Metab Case Rep 2018;2018:18-0128.
DOI: https://doi.org/10.1530/EDM-18-0128
Arya S, Barnabas R, Lila AR, et al. Clinical, hormonal, genetic, and molecular characteristics in androgen insensitivity syndrome in an Asian Indian cohort from a single centre in western India. Sex Dev 2021;15:253-61.
DOI: https://doi.org/10.1159/000517763
Hellmann P, Christiansen P, Johannsen TH, et al. Male patients with partial androgen insensitivity syndrome: a longitudinal follow-up of growth, reproductive hormones and the development of gynecomastia. Arch Dis Child 2012;97:403-9.
DOI: https://doi.org/10.1136/archdischild-2011-300584
Gulía C, Baldassarra S, Zangari A, et al. Androgen insensitivity syndrome. Eur Rev Med Pharmacol Sci 2018;22:3873-87.
Butler G. Incidence of gynaecomastia in Klinefelter syndrome adolescents and outcome of testosterone treatment. Eur J Pediatr 2021;180:3201-7.
DOI: https://doi.org/10.1007/s00431-021-04083-2
Raheem AA, Zaghloul AS, Sadek AMG, et al. The impact and management of gynecomastia in Klinefelter Syndrome. Front Reprod Health 2021;3:629673.
DOI: https://doi.org/10.3389/frph.2021.629673
Swerdlow AJ, Schoemaker MJ, Higgins CD, et al. Cancer incidence and mortality in men with Klinefelter syndrome: a cohort study. J Natl Cancer Inst 2005;97:1204–10.
DOI: https://doi.org/10.1093/jnci/dji240
Ward CM, Khalid K. Surgical treatment of grade III gynaecomastia. Ann R Coll Surg Engl 1989;71:226–8.
Estors Sastre B, Bragagnini Rodríguez P, Silva Bueno M, et al. Puberal gynecomastia: a comparison between the inferior periareolar approach and the concentric circle technique. Cir Pediatr 2013;26:129-34.
McNamara CT, Nuzzi LC, Firriolo JM, et al. Complications and quality of life following gynecomastia correction in adolescents and young men. Plast Reconstr Surg 2022;149:1062e-1070e.
DOI: https://doi.org/10.1097/PRS.0000000000009089
Fischer S, Hirsch T, Hirche C, et al. Surgical treatment of primary gynecomastia in children and adolescents. Pediatr Surg Int 2014;30:641-7.
DOI: https://doi.org/10.1007/s00383-014-3508-8
De Sanctis V, Soliman AT, Tzoulis P, Daar S, Di Maio S, Kattamis C. Unilateral breast enlargement in males during adolescence (10-19 years): Review of current literature and personal experience. Acta Biomed 2023;94:e2023004.
Fruhstorfer BH, Malata CM. A systematic approach to the surgical treatment of gynaecomastia. Br J Plast Surg 2003;56:237–46.
DOI: https://doi.org/10.1016/S0007-1226(03)00111-5
How to Cite
Zangari, A., Noviello, C., Todesco, C., Romano, M., Trotta, L., Botta, C., … Papparella, A. (2024). Satisfaction and results of the subareolar incision as treatment for gynecomastia in adolescents: experience of two centers. La Pediatria Medica E Chirurgica, 46(2). https://doi.org/10.4081/pmc.2024.336
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