Abstract

Objective: Surgical approaches to the treatment of gynecomastia are still popular due to concerns regarding the side effects of medical therapy, particularly with the failure of liposuction in the presence of excessive skin and fibroglandular tissue. We present here the results of a satisfaction questionnaire administered to patients who underwent surgery for the treatment of gynecomastia, drawing attention to the different surgical options.

Method: The medical charts of 60 cases who underwent surgery in two pediatric suregery centers using three different techniques, selected based on the Simon’s-classification, between 2001-2019 were reviewed retrospectively. The surgical approach was selected based on at least a 3-year follow-up period in cases with Grade-I and IIA, while there was no waiting period for patients with Grade-IIB and III. Satisfaction levels were determined according to the 5-point Likert-scale regarding how all patients evaluated the surgical outcome.

Results: The mean age of the respondents was 15.46-years (12–21), the mean duration of follow-up was 6.51-years (2–18), and 40% (n=24) of the patients had unilateral and 60% (n=36) had bilateral gynecomastia. The cases were examined individually in consultation with the departments of endocrinology and psychiatry. Of the total, 6-patients were found to have partial androgen insensitivity syndrome three with hypospadias and a history of long-term testosterone use. 10-patients with Grade-I and 26-patients with Grade-IIA underwent an infraareolar-semicircular-subcutaneous-mastectomy (ISSM); 20-patients with Grade-IIB underwent an infraareolar-crescent-skin-sland excision and mastectomy (ICSIEM); and 4-patients with Grade-III underwent a vertical-reduction-mammoplasty (VRM). A hemovac drain was inserted in all patients. Minor complications occurred in 3-patients in the early term and in 1-patient in the long term. The overall satisfaction rate of the patients was 98.3%.

Conclusion: The basic principle behind the treatment for gynecomastia, which constitutes a significant psychosocial health problem during adolescence, is the multidisciplinary management of cases with knowledge of all the available techniques so as to achieve the best outcome.

Cite as: Özaydın S, Emre Ş, Kuzdan MÖ, Beşik C, Özcan R, Topuzlu Tekant G. Adolesan jinekomastide cerrahi tedavi sonuçları. Çoc. Cer. Derg. 2021;35(3):95-102.