Surgical management of gynaecomastia: Experience from a tertiary health facility in Southwest Nigeria
Keywords:Breast, Gynaecomastia, Local Anaesthesia, Subcutaneous mastectomy, Breast, Gynaecomastia, Local anaesthesia, Subcutaneous mastectomy
Background: Gynaecomastia is the benign enlargement of the male breast as a result of glandular proliferation, usually resulting in feminine appearance. The treatment is usually surgical for cosmetic reasons.
Objective: To describe the local experience with the surgical treatment of gynaecomastia by conventional subcutaneous mastectomy.
Methods: This is a retrospective study of all cases of gynaecomastia seen at the surgical out-patient department of the Olabisi Onabanjo University Teaching Hospital, Sagamu, covering the period from January 2009 to October 2019.The data obtained included age, duration of symptoms, treatment, postoperative complications and type of anaesthesia.
Results: A total of twenty-three cases were seen. The mean age was 26.4±17.5 years with an age range of 15 to 84years. The mean duration of symptoms was 2.9±3.6 years. About 70% of the cases were aged less than 21years. Twenty-one patients (91.3%) had a subcutaneous mastectomy, and local anaesthesia was deployed for the procedure in 16 (76.2%) cases. Two patients (9.5%) developed postoperative haematoma while one patient developed severe keloid at the surgical site.
Conclusion: Subcutaneous mastectomy for gynaecomastia can be safely done under local anaesthesia and it gives a good cosmetic effect with minimal postoperative complications.
Hassan RM. Modified Benelli procedure for subcutaneous mastectomy: A randomised controlled trial. Am Med Surg 2019; 47: 19-23. http://doi.org/10.1016/j.amsu.2019.09.007
Cuhaci N, Polat SB, Evranos B, Ersoy R, Cakir B. Gynaecomastia; Clinical evaluation and management. Indian J Endocr Metab 2014; 18(2): 150-158.
Muneer A, LaghariZH, Shoikh AR, Laghari QA. Gynaecomastia: Management in a developing country. J AyubMed Coll Abbottabad 2009; 21(3): 7-11
Walker BP, Tofl AD. Endocrine disease. Davidsons Principles and Practice of Medicine 19th Edition. Churchill Livingstone London 2003: 706-707.
Rahmani S, Turton P, Shaaban A, Dali B. Overview of Gynaecomastia in the modern era and the Leeds Gynaecomastia investigation algorithm. Breast J 2011; 17: 246-255.
Baros AC, SampaioMde C. Gynaecomastia: pathophysiology, evaluation, and treatment. Sao Paulo Med J 2012; 130: 187-197.
Johnson RE, Murad MH. Gynaecomastia: Pathophysiology, Evaluation, and Management. Mayo Clin Proc 2009; 84(11): 1010-1015.
Gikas P, Mokbel J. Management of gynaecomastia. An update. Int J Clin Pract 2007; 61: 1209-1215.
Johnson RE, Kermott CA, Murad MH. Gynaecomastia – evaluation and current treatment options. Thera Clin Risk Manage 2011; 7: 145-148.
Braunstein CD. Clinical practice gynaecomastia. N Eng J Med 2007; 357(12): 1229-1237.
Bembo SA, Carlson HE. Gynaecomastia: Its features and when and how to treat it. Cleve Clin J Med 2004; 71: 511-517.
Carlson HE. Approach to the patient with gynaecomastia. J Clin Endocrinol Metab 2011; 96: 15-21.
Bhasin S. Testicular Disorders. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR (Editors). William textbook of Endocrinology 11th Edition, Philadelphia Saunders Elsevier: 2008: 669-674.
Handschin AE, Bietry D, Husler R, Constantinescu M, Banc A. Surgical treatment of gynaecomastia. – a 10-year analysis. World J Surg 2008; 32(1): 38-44.
Choi BS, Lee SR, Byun GY, Hurang SB, Kuo BH. The characteristics and sort term surgical outcome of adolescent gynaecomastia. Aesthetic Plast Surg 2017: 41(5): 1011-1021.
Fischer S, Hirsch T, Hirsche C, Kiefer J, Kueckelhaus M, Germann G, et al. Surgical treatment of primary gynaecomastia in children and adolescents. Paediatr Surg Int 2014; 30(6): 641-647.
Bailey SH, Guenther D, Constantine F, Rohrich RJ. Gynaecomastia management: an evolution and refinement in technique at UT Southwestern Medical Centre. Plast Reconstr Surg Glob Open 2016; 4 e734. http//refhub.elserver.com/S2049-0801(1G)30125-6/Sref11
Lanitis S, Starren E, Read J, Heymann T, Tekkis P, Hadjiminas DJ, et al. Surgical management of gynaecomastia: outcome from our experience. Breast 2008; 17(6): 596-603.
Longheu A, Medas F, Corrias F, Farris S, Tatti A, Pisano G, et al. Surgical managementof Gynaecomastia: Experience of a general surgery centre. G Chir 2016; 37(4): 150-154.
Lee BH, Kwon YJ, Park JW, Hwang JH, Kim KS, Lee SY. Gynaecomastia surgery is associated with improved nipple location in young Korean patients. Arch Plast Surg 2014; 41(6): 748-752
The articles and other materials published in the Annals of Health Research are protected by the Nigerian Copyright laws. The journal owns the copyright over every article, scientific and intellectual materials published in it. However, the journal grants all authors, users and researchers access to the materials published in the journal with the permission to copy, use and distribute the materials contained therein only for academic, scientific and non-commercial purposes.