Circumareolar Inferior Pedicle Mammaplasty for Treatment of Gynecomastia with Breast Ptosis

Gynecomastia is a benign enlargement of the male breast due to physiological or pathological factor that interferes with the balance between estrogens and androgens in the serum. Gynecomastia itself requires no treatment unless the persistant enlargement of the male breast is a source of embarrassment and/or distress for the adolescent or adult man. Indications for surgical treatment of gynecomastia are founded on two main objectives: (1) Restoration of male chest shape and (2) diagnostic evaluation of suspected breast lesions. The diagnosis begins with an adequate history and a thorough breast examination helped by laboratory tests and instrumental research. Several approaches for surgical treatment have been described in the literature. Some problems arise in patients who have significant enlargement and ptosis of the breast that will require skin reduction and in some patient requiring nipple-areola complex reduction. The complete circumareolar tech-nique creates the best aesthetic results, with fewer complications in patients with moderate and severe ptotic glandular breast enlargement that have skin redundancy combined with areolar enlargement. From 2007 through 2009, a total of 28 patients with moderate to severe gynecomastia were treated surgically using a complete circumareolar approach. All patients achieved a good aesthetic contour of the chest. Only one-patient had slightly skin retraction that resolved sponta-neously and another patient developed a seroma that resolved after a single aspiration.