Surgical Treatment of Gynecomastia Improves Quality of Life in Adolescents and Young Men
Joseph M. Firriolo, MD, Laura C. Nuzzi, BA, Carolyn M. Pike, MPH, John G. Meara, MD, DMD, Brian I. Labow, MD.
Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
PURPOSE: Adolescent gynecomastia is associated with psychosocial deficits. This longitudinal cohort study measures the impact of gynecomastia repair on adolescent health-related quality of life.
METHODS: Validated surveys were administered to adolescents and young men with persistent gynecomastia (>3 years) undergoing surgical correction and comparably aged male controls: Short-Form 36v2 (SF-36), Rosenberg Self-Esteem Scale (RSES), and Eating-Attitudes Test-26 (EAT-26). Cohorts completed surveys at baseline and postoperatively/follow-up at 6 months, 1 year, 3 years, and 5 years.
RESULTS: Forty-two gynecomastia (most frequently grades II and III) and 68 control subjects were included. Mean ages of patients at surgery and controls at baseline were 17.0 and 18.7 years, respectively. Preoperatively, gynecomastia subjects performed significantly worse than controls in five SF-36 domains (general health, vitality, social functioning, role-emotional, and mental health), and on the RSES and EAT-26. Gynecomastia patients demonstrated significant postoperative improvements in five SF-36 domains (physical functioning, role-physical, bodily pain, vitality, social functioning). These results largely did not differ by age and BMI category. Within one year, postoperative gynecomastia patients performed similarly to controls in all SF-36 domains and on the RSES.
CONCLUSION: Surgical correction of gynecomastia in adolescents and young men yielded measurable improvements in physical, social, and emotional wellbeing, largely unaffected by age and BMI category. Within one year, postoperative patients performed comparably to unaffected controls. Providers should be aware of the physical and psychosocial improvements surgery can provide young men with gynecomastia. Concerns regarding patient age and BMI should not constitute absolute contraindications to surgery.
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