Gynecomastia surgery: Difference between revisions

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{{CMG}}; {{AE}} {{HS}}
{{CMG}}; {{AE}} {{HS}}
==Overview==
==Overview==
Surgery is not the first-line treatment option for patients with gynecomastia.Surgery is usually reserved for patients with either [[psychological]] stresses, extensive gynecomastia or failure of medical treatment. The type of surgical technique depends on the extent of gynecomastia.
Surgery is not the first-line treatment option for patients with gynecomastia. Surgery is usually reserved for patients with either [[psychological stress]], extensive gynecomastia or failure of medical treatment. The type of surgical technique depends on the extent of gynecomastia.
==Surgery==
==Surgery==
*Surgery is not the first-line treatment option for patients with gynecomastia.<ref name="pmid15242307">{{cite journal |vauthors=Bembo SA, Carlson HE |title=Gynecomastia: its features, and when and how to treat it |journal=Cleve Clin J Med |volume=71 |issue=6 |pages=511–7 |year=2004 |pmid=15242307 |doi= |url=}}</ref>  
*Surgery is not the first-line treatment option for patients with gynecomastia.<ref name="pmid15242307">{{cite journal |vauthors=Bembo SA, Carlson HE |title=Gynecomastia: its features, and when and how to treat it |journal=Cleve Clin J Med |volume=71 |issue=6 |pages=511–7 |year=2004 |pmid=15242307 |doi= |url=}}</ref>  
*The aim of surgery is to achieve the normal appearance, with the smallest possible scar.<ref name="pmid17543732">{{cite journal| author=Narula HS, Carlson HE| title=Gynecomastia. | journal=Endocrinol Metab Clin North Am | year= 2007 | volume= 36 | issue= 2 | pages= 497-519 | pmid=17543732 | doi=10.1016/j.ecl.2007.03.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17543732  }} </ref>  
*The aim of surgery is to achieve the normal appearance, with the smallest possible scar.<ref name="pmid17543732">{{cite journal| author=Narula HS, Carlson HE| title=Gynecomastia. | journal=Endocrinol Metab Clin North Am | year= 2007 | volume= 36 | issue= 2 | pages= 497-519 | pmid=17543732 | doi=10.1016/j.ecl.2007.03.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17543732  }} </ref>  
*The surgical techniques used for gynecomastia depends on the extent of gynecomastia and proportion of different breast components ([[parenchyma]], [[fat]], loose skin).
*The surgical techniques used for gynecomastia depends on the extent of gynecomastia and proportion of different [[breast]] components ([[parenchyma]], [[fat]], loose skin).
*Most commonly used surgical technique is [[subcutaneous]] [[mastectomy]] with or without [[Liposuction|liposuction.]]<ref name="pmid21209041">{{cite journal| author=Carlson HE| title=Approach to the patient with gynecomastia. | journal=J Clin Endocrinol Metab | year= 2011 | volume= 96 | issue= 1 | pages= 15-21 | pmid=21209041 | doi=10.1210/jc.2010-1720 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21209041  }} </ref>
*Most commonly used surgical technique is [[subcutaneous]] [[mastectomy]] with or without [[Liposuction|liposuction.]]<ref name="pmid21209041">{{cite journal| author=Carlson HE| title=Approach to the patient with gynecomastia. | journal=J Clin Endocrinol Metab | year= 2011 | volume= 96 | issue= 1 | pages= 15-21 | pmid=21209041 | doi=10.1210/jc.2010-1720 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21209041  }} </ref>
*Extensive surgery, including skin resection, is done in patients with gynecomastia and excessive sagging of the breast tissue.<ref name="pmid19880691">{{cite journal| author=Johnson RE, Murad MH| title=Gynecomastia: pathophysiology, evaluation, and management. | journal=Mayo Clin Proc | year= 2009 | volume= 84 | issue= 11 | pages= 1010-5 | pmid=19880691 | doi=10.1016/S0025-6196(11)60671-X | pmc=2770912 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19880691  }} </ref>
*Extensive surgery, including skin resection, is done in patients with gynecomastia and excessive sagging of the breast tissue.<ref name="pmid19880691">{{cite journal| author=Johnson RE, Murad MH| title=Gynecomastia: pathophysiology, evaluation, and management. | journal=Mayo Clin Proc | year= 2009 | volume= 84 | issue= 11 | pages= 1010-5 | pmid=19880691 | doi=10.1016/S0025-6196(11)60671-X | pmc=2770912 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19880691  }} </ref>
*[[Liposuction]] alone can be done for pseudo gynecomastia.<ref name="pmid19880691">{{cite journal| author=Johnson RE, Murad MH| title=Gynecomastia: pathophysiology, evaluation, and management. | journal=Mayo Clin Proc | year= 2009 | volume= 84 | issue= 11 | pages= 1010-5 | pmid=19880691 | doi=10.1016/S0025-6196(11)60671-X | pmc=2770912 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19880691  }} </ref>
*[[Liposuction]] alone can be done for pseudogynecomastia.<ref name="pmid19880691">{{cite journal| author=Johnson RE, Murad MH| title=Gynecomastia: pathophysiology, evaluation, and management. | journal=Mayo Clin Proc | year= 2009 | volume= 84 | issue= 11 | pages= 1010-5 | pmid=19880691 | doi=10.1016/S0025-6196(11)60671-X | pmc=2770912 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19880691  }} </ref>
=== Complications ===
=== Complications ===
*Breast asymmetry
*Breast asymmetry
*Contour irregularity
*Contour irregularity
*[[Hematoma]]
*[[Hematoma]]
*Numbness of the nipple-[[areolar]] complex
*Numbness of the [[nipple]]-[[areolar]] complex
*Nipple [[necrosis]]
*Nipple [[necrosis]]
*Shedding of tissue due to loss of blood supply
*Shedding of tissue due to loss of blood supply
==Indications==
==Indications==
Surgery is usually reserved for patients with either:
Surgery is usually reserved for patients with either:
*[[Psychological]] stresses
*[[Psychological stress]]  
*Cosmetic problems
*Cosmetic problems
*Failure of [[Medical treatment|medical therapy]]
*Failure of [[Medical treatment|medical therapy]]

Revision as of 18:32, 21 August 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Husnain Shaukat, M.D [2]

Overview

Surgery is not the first-line treatment option for patients with gynecomastia. Surgery is usually reserved for patients with either psychological stress, extensive gynecomastia or failure of medical treatment. The type of surgical technique depends on the extent of gynecomastia.

Surgery

  • Surgery is not the first-line treatment option for patients with gynecomastia.[1]
  • The aim of surgery is to achieve the normal appearance, with the smallest possible scar.[2]
  • The surgical techniques used for gynecomastia depends on the extent of gynecomastia and proportion of different breast components (parenchyma, fat, loose skin).
  • Most commonly used surgical technique is subcutaneous mastectomy with or without liposuction.[3]
  • Extensive surgery, including skin resection, is done in patients with gynecomastia and excessive sagging of the breast tissue.[4]
  • Liposuction alone can be done for pseudogynecomastia.[4]

Complications

  • Breast asymmetry
  • Contour irregularity
  • Hematoma
  • Numbness of the nipple-areolar complex
  • Nipple necrosis
  • Shedding of tissue due to loss of blood supply

Indications

Surgery is usually reserved for patients with either:

References

  1. Bembo SA, Carlson HE (2004). "Gynecomastia: its features, and when and how to treat it". Cleve Clin J Med. 71 (6): 511–7. PMID 15242307.
  2. Narula HS, Carlson HE (2007). "Gynecomastia". Endocrinol Metab Clin North Am. 36 (2): 497–519. doi:10.1016/j.ecl.2007.03.013. PMID 17543732.
  3. Carlson HE (2011). "Approach to the patient with gynecomastia". J Clin Endocrinol Metab. 96 (1): 15–21. doi:10.1210/jc.2010-1720. PMID 21209041.
  4. 4.0 4.1 Johnson RE, Murad MH (2009). "Gynecomastia: pathophysiology, evaluation, and management". Mayo Clin Proc. 84 (11): 1010–5. doi:10.1016/S0025-6196(11)60671-X. PMC 2770912. PMID 19880691.

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