Treatment of adolescent gynecomastia using a bipedicle technique

Many methods have been described for the treatment of gynecomastia. Eleven adolescent boys have been managed with a bipedicle technique. These patients were evaluated for nipple-areolar viability, scarring, patient satisfaction, and hematoma or seroma formation. The pedicles providing blood supply to the nipple-areolar complex are reliable and are derived from the dermis and glandular breast tissue, thus minimizing nipple-areolar necrosis and hypopigmentation as a complication of the procedure. A periareolar incision provides adequate exposure for safe dissection and excision of the breast tissue, and facilitates reduction in the complex if needed. Good to excellent results were reported in all 11 patients at 2 weeks to 13 months of follow-up. There was no evidence of nipple-areolar necrosis and only one case of postoperative seroma formation. This approach utilizes a safe and reliable method of breast reduction that is particularly effective in the male adolescent group.