Abstract

Background: Male breast enlargement can occur transiently in up to three fourths of adolescent boys and is persistent in 7% of cases. The development of lipoplasty techniques has enabled treatment of this condition with only inconspicuous scarring. Objective: This article reviews the causes, diagnosis, and treatment of gynecomastia in the light of the authors' clinical experience. Methods: The causes and development of congenital, puberal, and acquired/induced gynecomastia are summarized. Indications for obtaining (1) endocrine tests, (2) plasma levels of estrogen, testosterone, and prolactin, and (3) biopsy are reviewed. Treatment methods focus on blunt cannula techniques and combination suction lipoplasty/excision procedures. Conclusions: Suction lipoplasty, often combined with excision, can be performed on an outpatient basis with local anesthesia with dependable results and no adverse effects.

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