Gynecomastia

Overview

In males, gynecomastia is equally a medical as well as a cosmetic problem. In question isa benign enlargement of the male breast which may be either physiological or pathological,caused by a disbalance in the serum levels of estrogens and androgens. There are three majortypes: a purely glandular formation, purely lipomatous tissue in pseudogynecomastia, and anintermediate for with varying proportions of the two types of tissue. While the physician isprompted to indicate surgical intervention in view of potential malignancy, the patient isinterested for cosmetic reasons. Therefore, the surgical approach should meet both requirements,i.e. the perfect elimination of the gland and the creation of a natural shape of the malechest.Under this diagnosis 102 patients have been operated on at the Department of Plastic Surgery,University Hospital Královské Vinohrady, Third Faculty of Medicine, Charles University,Prague 2, in the period 1998 through 2002. Indications for intervention were determined onendocrinological grounds, although the view of the patients was practically purely cosmetic.Theoperation as such constituted the extirpation of the gland through a periareolar incision,supplemented with liposuction to adjust the thickness of the subcutis at the site of the breasts.The intervention was a one stage operation. Satisfactory cosmetic results were attained in 95%of cases. The resected tissue underwent histological examination in every case. Although therehas been described an 8‰ occurrence of breast carcinoma in males, no malignancy has beenfound in the group operated on. Local complications of immediate healing occurred in 6.9% ofcases, most often seroma was in question. Late complications were represented first of all byaltered sensitivity of the nipple, namely in 22.5% of cases.The combination of gland extirpation with contouring the thoracic wall by liposuction can beconsidered to be a suitable method for treating this affection.

Key words:
gynecomastia - body contouring - breast tumors in males.