title: [External periareolar incision for subdermal mastectomy in men with gynecomastia].
abstract: BACKGROUND
  Gynecomastia describes a benign increase of the mammary gland in men. When medical treatment fails, symptoms and psychological alterations persist. Subdermal mastectomy is the definitive treatment and can be achieved by different incisions, each with potential complications. We undertook this study to present clinical characteristics of 11 patients with gynecomastia and the results obtained with subdermal mastectomy by means of external periareolar incision.
  
  
  METHODS
  A descriptive cohort study in male patients with gynecomastia was carried out in a third-level medical care hospital. Patients were treated with subdermal mastectomy by means of external periareolar incision.
  
  
  RESULTS
  There were 11 male patients with an average age of 19 years (range: 11-60 years), 3 patients (27.2%) with bilateral gynecomastia and 8 patients (72.7%) with unilateral gynecomastia. Average time of evolution was 22 months (range: 16-48 months), 9 patients (81.8%) reported pain, 11 patients (100%) reported psychological alterations with cutaneous alteration, 11 patients (100%) had normal secondary sexual characteristics, 1 patient (9%) had supernumerary nipple development, and 11 patients (100%) had well-defined lesions. According to Simon's classification: seven patients (63.6%) were classified as grade 1, three patients (27.2%) as grade 2 and one patient (9.09%) as grade 3. Each patient had a subdermal mastectomy with external periareolar incision, 11 patients (100%) had a histopathological report of gynecomastia; 1 patient (9.09%) displayed keloid healing and none displayed complications inherent to the surgical procedure.
  
  
  CONCLUSIONS
  Mastectomy by means of external periareolar incision is useful in the treatment of gynecomastia.
authors.affiliation: Departamento de Cirugía General, Unidad Médica de Alta Especialidad Puebla, Instituto Mexicano del Seguro Social, Polimédica Sur, Av. Cue Merlo 802-E, 73550 San Baltazar Campeche, Puebla, Puebla, México. dralmoja@hotmail.com
authors.forename: Alvaro
authors.initials: A
authors.lastname: Montiel-Jarquín
authors.forename: Pedro
authors.initials: P
authors.lastname: Reyes-Páramo
authors.forename: Gloria
authors.initials: G
authors.lastname: Ramos-Alvarez
authors.forename: Aurelio
authors.initials: A
authors.lastname: López-Colombo
authors.forename: Magdalena
authors.initials: M
authors.lastname: Tinajero-Esquivel
authors.forename: Betzabé
authors.initials: B
authors.lastname: Ruiz-León
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D006177:Gynecomastia / Q000601:surgery*; D006801:Humans; D008297:Male; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D009558:Nipples