Gynaecomastia in the adolescent: a surgically relevant condition

Gynaecomastia is a benign condition which is commonly seen in adolescent males. The aim of this study is to assess the complications and the cosmetic outcome of surgical treatment in the management of adolescent gynaecomastia.

Thirty-nine adolescent males had subcutaneous mastectomy for gynaecomastia at Booth Hall and Royal Manchester Children's Hospitals between 1995 - 2001 inclusive. A retrospective analysis was performed and in addition to chart review, personal and telephone interviews were conducted to assess the patients' satisfaction with the cosmetic results of the procedure.

Thirty-four patients (87%) had bilateral mastectomies and the remaining five (13%) had a unilateral procedure. The technique used was the standard subcutaneous mastectomy via a circumareolar skin incision (10). Early postoperative complications included haematoma (n = 3), seroma formation (n = 1), and wound infection (n = 1). Late complications included unequal breast sizes (n = 3) and redundant baggy appearance of the skin (n = 1). We contacted thirty-three patients to assess their satisfaction with the cosmetic results of the procedure. Twenty-nine (88%) were satisfied with their cosmetic appearance, compared to four (12%) reported "not satisfied".

Gynaecomastia in adolescent males is common and the majority of cases regress spontaneously within one year. Surgery is indicated if the condition fails to regress or if it is causing sufficient embarrassment to interfere with the patient's social life. Based on our experience, we believe that subcutaneous mastectomy through a circumareolar skin incision is a valid procedure for the treatment for adolescent gynaecomastia and provides satisfactory cosmetic results for this age group.