Contemporary Management of Gynecomastia

Dennis J Hurwitz; Armando A Davila

doi:10.1016/j.cps.2021.12.003

Contemporary Management of Gynecomastia

Clin Plast Surg. 2022 Apr;49(2):293-305. doi: 10.1016/j.cps.2021.12.003.

Authors

Dennis J Hurwitz¹, Armando A Davila²

Affiliations

¹ University of Pittsburgh Medical School, 3109 Forbes Avenue, Suite 500, Pittsburgh, PA 15213, USA. Electronic address: drhurwitz@hurwitzcenter.com.
² Hurwitz Center for Plastic Surgery; UNLV School of Medicine, 1701 W Charleston Blvd, Las Vegas, NV 89102, USA.

PMID: 35367036
DOI: 10.1016/j.cps.2021.12.003

Abstract

Contemporary management of gynecomastia includes transareolar excision of gland, disruption of inframammary fold, ultrasonic-assisted lipoplasty with muscular definition, bipolar radiofrequency tightening, pedicled NAC mastopexy with boomerang pattern excision and J torsoplasty, NAC grafts with hockey stick excision pattern, and pectoralis muscle lipoaugmentation. Therapeutic options are arranged across a modified Simon classification. The aesthetic goal is near total glandular reduction, with proper position and shape of the nipple areolar complexes, and masculinity with skin adherence reflecting musculoskeleton. Clinical cases demonstrate these multiple approaches, successes, and pitfalls. Complications relate to delayed healing caused by excessive closure tension or inadequate or inappropriate treatment.

Keywords: Bipolar radiofrequency; Boomerang pattern correction of gynecomastia; Breast ptosis; Gynecomastia; Lipoaugmentation of pectoralis muscle; Liposuction; Simon classification of gynecomastia; Skin tightening.

Publication types

Review

MeSH terms

Gynecomastia* / surgery
Humans
Lipectomy*
Male
Mammaplasty*
Nipples / surgery
Treatment Outcome