Choi Byung Seo, Lee Sung Ryul, Byun Geon Young, Hwang Seong Bae, Koo Bum Hwan
Department of Surgery, Damsoyu Hospital, 213 Bongeunsa-ro, Gangnam-gu, Seoul, Korea.
Aesthetic Plast Surg. 2017 Oct;41(5):1011-1021. doi: 10.1007/s00266-017-0886-z. Epub 2017 Apr 27.
Most adolescent gynecomastia is resolved spontaneously in 3 years. But, persistent gynecomastia could have a negative influence on psychoemotional development on adolescence. The purpose of this study is to report the characteristics of adolescent gynecomastia patients who received the surgeries, and discuss the short-term surgical outcomes.
Of the 1454 patients who underwent gynecomastia surgery at Damsoyu hospital from January 2014 to May 2016, 71 were adolescents. Subcutaneous mastectomy with liposuction was performed for adolescent patients who had gynecomastia for more than 3 years and showed psychosocial distress. Demographic and outcome variables were retrospectively analyzed.
The mean age was 17.5 ± 0.77 years old. All gynecomastia cases were bilateral. Simon's grade IIa (35 patients, 49.3%) was the most common, and grade III was not observed. Fifty-one patients (71.8%) were classified as having a glandular-type breast component. Fourteen patients (19.7%) had complications, but only 3 cases (4.2%) required revision. Most of the patients (70 patients, 98.6%) were satisfied with the esthetic results, and the average 5-point Likert score was 4.85 ± 0.40. Recurrence was not observed. As the Simon's grade increased from I to IIA, a higher BMI, larger amounts of breast tissue, and longer operation times were observed.
Gynecomastia that did not regress spontaneously was mostly the glandular type, so not only liposuction but also surgical removal of glandular tissue is necessary. Surgical treatment, selectively performed in patients who have had gynecomastia for 3 years, and have experienced psychosocial distress, could be an acceptable treatment for adolescent gynecomastia.
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大多数青春期男性乳腺增生症会在3年内自行消退。但是，持续性男性乳腺增生症可能会对青少年的心理情感发育产生负面影响。本研究的目的是报告接受手术治疗的青春期男性乳腺增生症患者的特征，并探讨手术的短期效果。
在2014年1月至2016年5月期间于Damsoyu医院接受男性乳腺增生症手术的1454例患者中，71例为青少年。对患有男性乳腺增生症超过3年且有心理社会困扰的青少年患者进行皮下乳房切除术并吸脂。对人口统计学和结果变量进行回顾性分析。
平均年龄为17.5±0.77岁。所有男性乳腺增生症病例均为双侧。西蒙氏IIa级（35例患者，49.3%）最为常见，未观察到III级。51例患者（71.8%）被归类为具有腺体型乳房成分。14例患者（19.7%）出现并发症，但仅3例（4.2%）需要再次手术。大多数患者（70例患者，98.6%）对美学效果满意，平均5级李克特评分为4.85±0.40。未观察到复发。随着西蒙氏分级从I级增加到IIA级，观察到更高的体重指数、更多的乳房组织量和更长的手术时间。
未自发消退的男性乳腺增生症大多为腺体型，因此不仅需要吸脂，还需要手术切除腺体组织。对于患有男性乳腺增生症3年且有心理社会困扰的患者，选择性地进行手术治疗可能是青春期男性乳腺增生症可接受的治疗方法。
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