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Barriers to the Effective Management of Gynecomastia in Adolescents

Arora, Yingyot BS; Mittal, Rhiya Ridhi BS; Williams, Eva Adanna MD; Thaller, Seth Ray MD

doi: 10.1097/SCS.0000000000005999
Original Articles

Background: The aim of this study was to explore the impacts of gynecomastia on adolescents, explore the surgical and psychological success of mastectomy, and evaluate the adequacy of insurance guidelines and coverage.

Methods: American College of Surgeons National Surgical Quality Improvement Program (NSQIP) surgical database from 2010 to 2014 was evaluated for current procedural terminology codes 19300 and 19303, representing mastectomies for gynecomastia and complete mastectomies respectively to compare surgical site complications.

Results: Of 1132 procedures for mastectomy for gynecomastia 1.5% of patients (n = 17) were associated with postoperative superficial surgical site complications. In the same timeframe, a total of 33,124 procedures for simple, complete mastectomy performed with a postoperative surgical complication rate of 2.2% (n = 721). Results of a Chi-squared goodness of fit χ2 (1, N = 34,997) = 2.10, P > 0.05 suggests no statistically significant difference between incidence of surgical site complications for a mastectomy for gynecomastia versus typical mastectomy.

Discussion: High surgical success rate, coupled with significant improvements in psychosocial functioning suggests that mastectomy is a highly effective intervention for adolescents with gynecomastia. However, due to vague and inadequate coverage and evaluation criteria surgery is often not performed. This paper offers a framework for developing a quantitative system by which to evaluate surgical candidates by adopting well-established guidelines currently in use for reduction mammoplasties and suggests further analysis into a cost/benefit analysis for coverage of the procedure.

University of Miami, Miller School of Medicine, Division of Plastic Aesthetic and Reconstructive Surgery, DeWitt Daughtry Department of Surgery, Miami, FL.

Address correspondence and reprint requests to Yingyot Arora, BS, University of Miami, Miller School of Medicine, 1600 NW 10th Ave #1140, Miami, FL 33136; E-mail:

Received 19 June, 2019

Accepted 18 August, 2019

The authors report no conflicts of interest.

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© 2019 by Mutaz B. Habal, MD.