Bodybuilder Gynecomastia: Etiology, Characteristics, and Management | ||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||
| Article 4, Volume 45, Issue 3, July 2021, Pages 133-139 PDF (11.19 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejprs.2021.183853 | ||
| Authors | ||
| Helmy El Wakeel* ; Mohamed H. Abou Arab; Hassan M. Kholosy | ||
| The Department of Plastic Surgery, Faculty of Medicine, Alexandria University, Egypt | ||
| Abstract | ||
| Background: Bodybuilder gynecomastia represent a special entity, being secondary to use/abuse of anabolic steroids leading to glandular enlargement as the sole or the main underlying pathology with an occasional fatty element. Typical management entails complete gland excision through the least visible scar, (typically periareolar) with preservation of pectoral muscle and fascia integrity. Adjuvant small volume liposuction is needed in some cases with a fatty element. Patients and Methods: The study enrolled a series of 13 bodybuilders with gynecomastia and a history of anabolic steroids use/abuse. All cases presented with glandular tissue enlargement, with fatty element noted in 4 cases. Operations were done under general anesthesia with tumescent fluid infiltration. Through an inferior periareolar incision, almost the whole enlarged gland was excised, with adjuvant liposuction as indicated. Meticulous hemostasis and preservation of pectoral fascia integrity aimed to minimize excessive scaring beneath a thin overlying areolar skin flap and possible subsequent adhesions and contour irregularities. Results: All cases achieved final satisfactory results with high patients satisfaction. Early complications included minor hematoma in one case. Probably this was the cause of later dynamic depression seen with pectoral muscle contraction noted at 6 months follow-up and resolved spontaneously during the next year. Conclusion: Bodybuilder gynecomastia management entails almost complete glandular tissue excision with limited liposuction in some cases. Meticulous technique including proper hemostasis is important to avoid even the minor contour irregularities and other complications in such demanding cases seeking perfect shape. | ||
| References | ||
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REFERENCES 1- Rahmani S., Turton P., Shaaban A. and Dall B.: Overview of gynecomastia in the modern era and the Leeds Gynaecomastia Investigation algorithm. Breast J., 17: 246-255, 2011. 2- Schonfeld W.A.: Gynecomastia in adolescence: Effect on body image and personality adaptation. Psychosom. Med., 24: 379-389, 1962. 3- Fagerlund A., Lewin R., Rufolo G., et al.: Gynecomastia: A systematic review. J. Plast. Surg. Hand Surg., 49: 311- 318, 2015. 4- Ratnam B.V.: A new classification and treatment protocol for gynecomastia. Aesthet. Surg. J., 29: 26-31, 2009. 5- Lewis C.M.: Lipoplasty: treatment for gynaecomastia. Aesthetic Plast. Surg., 9: 287-292, 1985. 6- Morselli P.G. and Morellini A.: Breast reshaping in gynecomastia by the ''pull-through technique'': Considerations after 15 years. Eur. J. Plast. Surg., 35 (5): 365-371, 2012. 7- Lista F. and Ahmad J.: Power-assisted liposuction and the pull through technique for the treatment of gynecomastia. Plast. Reconst. Surg., 121 (3): 740-7, 2008. 8- Hammond D.C., Arnold J.F., Simon A.M. et al.: Combined use of ultrasonic liposuction with the pull-through technique for the treatment of gynecomastia. Plast. Reconst. Surg., 112 (3): 891-5, 2003. 9- Kim D.H., Byun I.H., Lee W.J., et al.: Surgical management of gynecomastia: subcutaneous mastectomy and liposuction. Aesthet. Plast. Surg., 40: 877-884, 2016. 10- Bowman J.D., Kim H. and Bustamante J.J.: Drug-induced gynecomastia. Pharmacotherapy, 32: 1123-1140, 2012. 11- Pope H.G. and Katz D.L.: Psychiatric and medical effects of anabolic-androgenic steroid use: A controlled study of 160 athletes. Arch. Gen. Psychiatry, 51: 375-382, 1994. 12- Blau M. and Hazani R.: Correction of Gynecomastia in Body Builders and Patients with Good Physique Plast. Reconstr. Surg., 135: 1-9, 2015. 13- Aiache A.E.: Surgical treatment of gynecomastia in the bodybuilder. Plast. Reconstr. Surg., 83: 61-66, 1989. 14- Reyes R.J., Zicchi S., Hamed H., et al.: Surgical correction of gynaecomastia in bodybuilders. Br. J. Clin. Pract., 49: 177-179, 1995. 15- Babigian A. and Silverman R.T.: Management of gynecomastia due to use of anabolic steroids in bodybuilders. Plast. Reconstr. Surg.,107: 240-242, 2001. 16- Simon B.E., Hoffman S. and Kahn S.: Classification, and surgical correction of gynecomastia. Plast. Reconstr. Surg., 51: 48-52, 1973. | ||
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