title: Correction of gynecomastia in body builders and patients with good physique.
abstract: BACKGROUND
  Temporary gynecomastia in the form of breast buds is a common finding in young male subjects. In adults, permanent gynecomastia is an aesthetic impairment that may result in interest in surgical correction. Gynecomastia in body builders creates an even greater distress for patients seeking surgical treatment because of the demands of professional competition. The authors present their experience with gynecomastia in body builders as the largest study of such a group in the literature.
  
  
  METHODS
  Between the years 1980 and 2013, 1574 body builders were treated surgically for gynecomastia. Of those, 1073 were followed up for a period of 1 to 5 years. Ages ranged from 18 to 51 years. Subtotal excision in the form of subcutaneous mastectomy with removal of at least 95 percent of the glandular tissue was used in virtually all cases. In cases where body fat was extremely low, liposuction was performed in fewer than 2 percent of the cases.
  
  
  RESULTS
  Aesthetically pleasing results were achieved in 98 percent of the cases based on the authors' patient satisfaction survey. The overall rate of hematomas was 9 percent in the first 15 years of the series and 3 percent in the final 15 years. There were no infections, contour deformities, or recurrences.
  
  
  CONCLUSIONS
  This study demonstrates the importance of direct excision of the glandular tissue over any other surgical technique when correcting gynecomastia deformities in body builders. The novice surgeon is advised to proceed with cases that are less challenging, primarily with patients that require excision of small to medium glandular tissue.
  
  
  METHODS
  Therapeutic, IV.
authors: White Plains, N.Y.; and Beverly Hills, Calif. From private practice.
authors: Mordcai
authors: M
authors: Blau
authors: Ron
authors: R
authors: Hazani
mesh_terms: D000293:Adolescent; D000328:Adult; D045930:Anabolic Agents / Q000009:adverse effects; D001940:Breast / Q000473:pathology; D004954:Esthetics; D006177:Gynecomastia / Q000139:chemically induced / Q000473:pathology / Q000601:surgery*; D006406:Hematoma / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D006965:Hyperplasia; D007431:Intraoperative Complications; D015187:Lipectomy / Q000009:adverse effects; D008297:Male; D016462:Mammaplasty / Q000379:methods*; D015414:Mastectomy, Subcutaneous / Q000379:methods*; D008875:Middle Aged; D017060:Patient Satisfaction; D010369:Pectoralis Muscles / Q000098:blood supply / Q000293:injuries; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013008:Somatotypes; D014891:Weight Lifting; D055815:Young Adult
chemical_list: D045930:Anabolic Agents
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