Gynecomastia

Abstract

Gynecomastia is a common benign condition marked by male breast enlargement. It is usually caused by an increased estrogen-to-androgen ratio. Proper assessment requires a thorough history and physical examination to rule out physiologic and iatrogenic causes. It is critical to rule out male breast cancer. Surgical treatment for mild gynecomastia entails liposuction with glandular excision. More advanced gynecomastia may require staged surgical procedures and the use of techniques such as skin excision, breast reduction, subcutaneous mastectomy, and free nipple grafting. There are few contraindications, and patient satisfaction is typically high. To successfully treat gynecomastia, the clinician must have a full understanding of its pathogenesis.