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Correction of Gynecomastia in Body Builders and Patients with Good Physique

Blau, Mordcai M.D.; Hazani, Ron M.D.

Plastic & Reconstructive Surgery: February 2015 - Volume 135 - Issue 2 - p 425–432
doi: 10.1097/PRS.0000000000000887
Cosmetic: Original Articles
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Background: Temporary gynecomastia in the form of breast buds is a common finding in young male subjects. In adults, permanent gynecomastia is an aesthetic impairment that may result in interest in surgical correction. Gynecomastia in body builders creates an even greater distress for patients seeking surgical treatment because of the demands of professional competition. The authors present their experience with gynecomastia in body builders as the largest study of such a group in the literature.

Methods: Between the years 1980 and 2013, 1574 body builders were treated surgically for gynecomastia. Of those, 1073 were followed up for a period of 1 to 5 years. Ages ranged from 18 to 51 years. Subtotal excision in the form of subcutaneous mastectomy with removal of at least 95 percent of the glandular tissue was used in virtually all cases. In cases where body fat was extremely low, liposuction was performed in fewer than 2 percent of the cases.

Results: Aesthetically pleasing results were achieved in 98 percent of the cases based on the authors’ patient satisfaction survey. The overall rate of hematomas was 9 percent in the first 15 years of the series and 3 percent in the final 15 years. There were no infections, contour deformities, or recurrences.

Conclusions: This study demonstrates the importance of direct excision of the glandular tissue over any other surgical technique when correcting gynecomastia deformities in body builders. The novice surgeon is advised to proceed with cases that are less challenging, primarily with patients that require excision of small to medium glandular tissue.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Video Discussion by Alan Matarasso, M.D., is available online for this article.Coding Perspective for this article is on page 431.

White Plains, N.Y.; and Beverly Hills, Calif.

From private practice.

Received for publication February 14, 2014; accepted May 28, 2014.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Supplemental digital content is available for this article. A direct URL citation appears in the text; simply type the URL address into any Web browser to access this content. A clickable link to the material is provided in the HTML text of this article on the Journal’s Web site (www.PRSJournal.com).

A Video Discussion by Alan Matarasso, M.D., accompanies this article. Go to PRSJournal.com and click on “Video Discussions” in the “Videos” tab to watch.

A Hot Topic Video by Editor-in-Chief Rod J. Rohrich, M.D., accompanies this article. Go to PRSJournal.com and click on Plastic Surgery Hot Topics in the Videos tab to watch.

Mordcai Blau, M.D., Private Practice, 12 Greenridge Avenue White Plains, N.Y. 10605

©2015American Society of Plastic Surgeons