Gynecomastia

Gynecomastia is the benign proliferation of glandular tissue in the male breast.

It appears for the first time between 10 and 12 years of age, with greater prevalence between 13 and 14 years of age.

Hormonal fluctuations during puberty cause physiological gynecomastia in up to 65% of pubertal boys, but it resolves spontaneously in 75% of cases within the following two years.

Many children who present for surgical evaluation of gynecomastia are overweight and weight loss should be encouraged before surgery is recommended.

Although many adolescent boys come requesting surgery, the most appropriate therapy is the expectant attitude.

Indications for surgical correction include pain, tenderness, or embarrassment sufficient to interfere with the patient's daily activities. Subcutaneous mastectomy through a periareolar incision and liposuction are both options used for such correction.

SCIENTIFIC EVIDENCE

* GW Holcomb, J Patrick Murphy, DJ Ostlie. Aschcraft´s Pediatric Surgery 6º Ed.

* P Mattei. Fundamentals of Pediatric Surgery.

* JM Hutson, M O’Brien, SW Beasley, WJ Teague, SK King. Jones’ Clinical Paediatric Surgery 7º Ed.

* MM Ziegler, RG Azizkhan, D von Allmen, TR Weber. Operative Pediatric Surgery 2º Ed.

* MD Stringer, KT Oldham, PDE Mouriquand. Pediatric Surgery and Urology 2º Ed.

* AG Coran. Pediatric Surgery 7º Ed.

* CP Coppola, AP Kennedy Jr, RJ Scorpio. Pediatric Surgery Diagnosis and Treatment.

* P Puri, M Höllwarth. Pediatric Surgery Diagnosis and Management.

* GL Kaiser. Symptoms and Signs in Pediatric Surgery.