title: Long-Term Follow-up of Recurrence and Patient Satisfaction After Surgical Treatment of Gynecomastia.
abstract: BACKGROUND
  "Gynecomastia" is an enlargement of the male breast. Our study aims to assess patient satisfaction as well as evaluate differences in recurrence rates in lipomatous and glandular gynecomastia 10-19 years postoperatively.
  
  
  METHODS
  Forty-one gynecomastia patients undergoing surgical treatment from 1997 to 2005 were invited for a follow-up examination 10-19 years postoperatively. Of these, 16 patients presented for a clinical examination. Patient satisfaction was measured with a validated questionnaire [consultation satisfaction questionnaire (CSQ)-9]. Furthermore, photo-material and patient charts were evaluated concerning preoperative macroscopical type of gynecomastia, BMI, and operative technique.
  
  
  RESULTS
  Mean follow-up time was 13.8 years (range: 10.5-19 years). Eight patients (50%) had presented with lipomatous and eight patients (50%) with glandular gynecomastia prior to surgery. One of the patients with glandular gynecomastia (12.5%) presented with recurrence at the time of follow-up, while five of the eight patients showing lipomatous gynecomastia (62.5%) presented with recurrence. Interestingly, younger patient groups tend to be more satisfied with the operative treatment of gynecomastia than older patient groups, especially regarding the improvement of self-esteem.
  
  
  CONCLUSIONS
  Long-term follow-up results showed that recurrence rates are significantly higher in patients with lipomatous gynecomastia than in patients with glandular gynecomastia, with BMI increase in patients with glandular and lipomatous gynecomastia showing no statistically significant differences. Furthermore, general patient satisfaction and improvement of self-esteem was higher in younger patient groups than older patient groups.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
  
  
  BACKGROUND
  DRKS00009630.
authors.affiliation: Department of Plastic and Hand Surgery, University of Freiburg Medical Center, Faculty of Medicine, Hugstetter Strasse 55, 79106, Freiburg, Germany. fricke.alba@gmail.com.
authors.forename: A
authors.identifier: http://orcid.org/0000-0003-4556-972X
authors.initials: A
authors.lastname: Fricke
authors.affiliation: Department of Plastic and Hand Surgery, University of Freiburg Medical Center, Faculty of Medicine, Hugstetter Strasse 55, 79106, Freiburg, Germany.
authors.forename: G M
authors.initials: GM
authors.lastname: Lehner
authors.affiliation: Department of Plastic and Hand Surgery, University of Freiburg Medical Center, Faculty of Medicine, Hugstetter Strasse 55, 79106, Freiburg, Germany.
authors.forename: G B
authors.initials: GB
authors.lastname: Stark
authors.affiliation: Department of Plastic and Hand Surgery, University of Freiburg Medical Center, Faculty of Medicine, Hugstetter Strasse 55, 79106, Freiburg, Germany. Vincenzo.penna@uniklinik-freiburg.de.
authors.forename: V
authors.initials: V
authors.lastname: Penna
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D005500:Follow-Up Studies; D006177:Gynecomastia / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012649:Self Concept; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Follow-up; Gynecomastia; Patient satisfaction; Self-esteem