Department of Pediatric Surgery, University of Health Sciences Turkey, Dr Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, BeştepelerMah, AlparslanTürkeş Cad. No: 27 Beştepe, 06560, Ankara, Turkey.
Pediatr Surg Int. 2024 Mar 27;40(1):92. doi: 10.1007/s00383-024-05671-7.
Despite being a common condition in puberty, only 5-10% of pubertal gynecomastia need surgical treatment. Here the authors present their experiences with infra-areolar subcutaneous mastectomy in the surgical treatment of adolescent gynecomastia.
The records of patients who underwent infra-areolar subcutaneous mastectomy for adolescent gynecomastia between January 2004 and December 2021 were reviewed retrospectively. The patients' demographic data, complaints and clinical presentation, physical examination, laboratory and radiological findings, surgical management, and postoperative follow-ups were evaluated. The patients were evaluated according to the localization of the gynecomastia (unilateral/bilateral) and according to the patients' body mass index (BMI) (normal/overweight).
A total of 21 boys with a mean age of 15 ± 1.4 years were operated by the senior author and infra-areolar subcutaneous mastectomy by a semilunar incision was performed for adolescent gynecomastia. The mean duration of the complaint was 24.2 ± 10.9 months. Gynecomastia was bilateral in 15 (71.5%) and unilateral in 6 (28.5%) of the patients. Sixteen patients (76.2%) were normal weight, 5 (23.8%) were overweight. Chromosomal anomaly and hypogonadism were detected in two patients. Pseudoangiomatous stromal hyperplasia was detected in the pathology of one patient. The mean follow-up time was 2.7 ± 1 years, seroma developed in 2 patients at the early postoperative period. Their long-term follow-up was uneventful without complication.
The results of infra-areolar subcutaneous mastectomy are very promising in pubertal gynecomastia due to good skin elasticity and without obesity in the adolescent age group. We believe that this method provides an almost invisible incision and a natural pectoral appearance for adolescent patients who have experienced serious emotional problems related to their body images.
尽管青春期男性乳房发育症是一种常见病症，但仅有 5-10%需要手术治疗。作者在此介绍他们在青少年男性乳房发育症的手术治疗中采用乳晕下皮下乳房切除术的经验。
回顾性分析 2004 年 1 月至 2021 年 12 月期间因青少年男性乳房发育症接受乳晕下皮下乳房切除术的患者的病历。评估患者的人口统计学数据、主诉和临床表现、体格检查、实验室和影像学检查、手术管理和术后随访。根据男性乳房发育症的定位（单侧/双侧）和患者的体重指数（BMI）（正常/超重）对患者进行评估。
由资深作者对 21 名平均年龄为 15 ± 1.4 岁的男孩进行了手术，采用半月形切口行乳晕下皮下乳房切除术治疗青少年男性乳房发育症。抱怨的平均持续时间为 24.2 ± 10.9 个月。15 例（71.5%）患者为双侧男性乳房发育症，6 例（28.5%）为单侧男性乳房发育症。16 例（76.2%）患者体重正常，5 例（23.8%）超重。2 例患者检测到染色体异常和性腺功能减退。1 例患者的病理检查发现假性血管基质增生。平均随访时间为 2.7 ± 1 年，2 例患者在术后早期出现血清肿。他们的长期随访没有出现并发症。
由于青少年时期皮肤弹性良好且没有肥胖，乳晕下皮下乳房切除术在青春期男性乳房发育症中的效果非常理想。我们相信，对于因身体形象问题而经历严重情绪问题的青少年患者，这种方法提供了几乎不可见的切口和自然的胸肌外观。
