Gynecomastia: what the surgeon needs to know

The purpose of this review is to present the complex underlying pathophysiology that can form the basis of this common condition.

More than 20 years of clinical experience in endocrinology and plastic surgery and a review of the English-language literature were used to form the basis of this review.

While idiopathic and physiologic causes are frequent, there are multiple, significant, underlying disorders that can result in gynecomastia, including chronic illness, cancer, medications, syndromes, and a variety of endocrinopathies.

Both history and physical examination are frequently sufficient to make an appropriate diagnosis. In patients who do not have a definitive etiology of their gynecomastia, a screening battery of laboratory tests is sufficient to rule out significant pathophysiology, although these tests may be difficult to interpret in children and adolescents. An endocrinology consultation is suggested whenever an abnormal screening laboratory test occurs or if there are any other suggestions of underlying endocrinopathy.