medigraphic.com
ISSN 1029-3035 (Electronic)

2019, Number 2

<< Back Next >>

Mediciego 2019; 25 (2)

Surgical treatment of pubertal gynecomastia with infiltrative local anesthesia

Ramírez-Lara EJ, Mamani-Choque E, Méndez-Ortega I

Language: Spanish
References: 18
Page: 62-71
PDF size: 423.32 Kb.


ABSTRACT

Introduction: gynecomastia is defined as the benign growth of the mammary gland of man, a secondary process to glandular proliferation. The aesthetic alterations that it causes have a negative impact on those who suffer from it. After two years, pharmacological treatment is not usually effective and surgery is recommended as the only option.
Objective: to present the case of a teenager diagnosed with pubertal gynecomastia and surgically treated. Despite being this frequent disease, few patients accept surgical treatment.
Case presentation: male patient of 16 years of age, white, with a history of overweight since childhood and no disease associated with his current condition. He reported that approximately from 11 or 12 years old he noticed an increase in the nipple volume, associated with pain of moderate intensity at the pressure and palpation. He underwent laboratory tests to rule out a possible hormonal disorder and a diagnostic ultrasound of both breasts. Surgery was recommended as a viable option (simple liposuction, combined with bilateral adenectomy). This patient was the first pediatric case surgically treated at the institution using infiltrative local anesthesia.
Conclusions: when spontaneous regression to the normal state does not occur, the only treatment option is surgical intervention, which few patients accept. In this case, the affected youth and his family gave their consent for the operation, which gave the expected results from the aesthetic point of view.


REFERENCES

  1. Longheu A, Medas F, Corrias F, Farris D, Tatti A, Pisano G, et al. Surgical management of gynecomastia: experience of a general surgery center. G Chir [Internet]. Ago 2016 [citado 21 Ene 2017];37(4):150-4. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5161216/pdf/150- 154.pdf

  2. Mieritz MG, Christiansen P, Jensen MB, Joensen UN, Nordkap L, Olesen IA, et al. Gynaecomastia in 786 adult men: clinical and biochemical findings. Eur J Endocrinol [Internet]. May 2017 [citado 12 Ene 2017]:176(5):555-66. Disponible en: https://www.researchgate.net/profile/Inge_Olesen/publication/313554470_Gynaecomastia_in_786_Ad ult_Men_-_Clinical_and_Biochemical_findings/links/5aa82616a6fdcc1b59c63844/Gynaecomastia-in- 786-Adult-Men-Clinical-and-Biochemical-findings.pdf

  3. Benito-Ruiz J, Raigosa M, Manzano M, Salvador L. Nuevo paradigma del tratamiento quirúrgico de la ginecomastia. Cir. plást. iberolatinoam. [Internet]. Jun 2013 [citado 12 Ene 2018];39(2):121-7. Disponible en: http://scielo.isciii.es/pdf/cpil/v39n2/original2.pdf

  4. Núñez-Rodríguez FJ, Artola-Aizalde E, Cancela-Muñiz V, Fernández-Ramos C, Rodrigo-Palacios J. Ginecomastia. Fisiopatología y actualización de las opciones terapéuticas. Bol Pediatr [Internet]. 2010 [citado 12 Ene 2017];50(214):263-71. Disponible en: https://www.sccalp.org/documents/0000/1673/BolPediatr2010_50_263-271.pdf

  5. Thiénot S, Bertheuil N, Carloni R, Méal C, Aillet S, Herlin C, et al. Postero-inferior pedicle surgical technique for the treatment of grade III gynecomastia. Aesthetic Plast Surg [Internet]. Jun 2017 [citado 12 Ene 2017];41(3):531-41. Disponible en: https://hal-univ-rennes1.archives-ouvertes.fr/hal- 01560208/document

  6. Montiel-Jarquín AJ, Reyes-Páramo P, Ramos-Álvarez G, López-Colombo A, Tinajero-Esquivel M, Ruiz-León B. Mastectomía subdérmica mediante incisión periareolar externa en hombres con ginecomastia. Cir Cir [Internet]. Oct 2007 [citado 12 Ene 2017];75(5):327-31. Disponible en: https://www.medigraphic.com/pdfs/circir/cc-2007/cc075b.pdf

  7. Castillo P. Ginecomastia. Cuad. Cir. [Internet]. 2003 [citado 12 Ene 2017];17(1):52-7. Disponible en: http://revistas.uach.cl/pdf/cuadcir/v17n1/art09.pdf

  8. Araujo-Herrera O. Ginecomastia fisiológica puberal. Rev Cubana Pediatr [Internet]. Dic 2014 [citado 21 Ene 2107];86(4):495-501. Disponible en: http://scielo.sld.cu/pdf/ped/v86n4/ped10414.pdf

  9. Kasielska A, Antoszewski B. Surgical management of gynecomastia: an outcome analysis. Ann Plast Surg [Internet]. Nov 2013 [citado 21 Ene 2017];71(5):471-5. Disponible en: https://pdfs.devjournals2013. lww.com/annalsplasticsurgery/2013/11000/Surgical_Management_of_Gynecomastia__A n_Outcome.9.pdf

  10. Barrantes-Rodríguez K. Ginecomastia: manifestaciones, etiología, abordaje diagnóstico y tratamiento. Med. leg. Costa Rica [Internet]. Mar 2016 [citado 27 Jul 2107];33(1):205-10. Disponible en:http://www.scielo.sa.cr/pdf/mlcr/v33n1/1409-0015-mlcr-33-01-00205.pdf

  11. Calderón W, Cabello R, Calderón D, Olguín F, Israel G. Tratamiento quirúrgico de la región mamaria masculina prominente. Cir. plást. iberolatinoam. [Internet]. Mar 2010 [12 Ene 2017];36(1):19- 24. Disponible en: http://scielo.isciii.es/pdf/cpil/v36n1/original3.pdf

  12. Morcos RN, Kizy T. Gynecomastia: when is treatment indicated? J Fam Pract [Internet]. Dic 2012 [citado 12 Ene 2017];61(12):719-25. Disponible en: https://mdedge-files-live.s3.us-east- 2.amazonaws.com/files/s3fs-public/Document/September-2017/6112JFP_Article1.pdf

  13. Brafa A, Campana M, Grimaldi L, Nisi G, Brandi C, Lazzeri D, et al. Management of gynecomastia: an outcome analysis in a multicentric study. Minerva Chir [Internet]. Oct 2011 [citado 27 Jul 2017];66(5):375-84. Disponible en: https://www.researchgate.net/profile/Davide_Lazzeri/publication/51830480_Management_of_gynecom astia_An_outcome_analysis_in_a_multicentric_study/links/55cb096708aeca747d69fd91/Managementof- gynecomastia-An-outcome-analysis-in-a-multicentric-study.pdf

  14. Prado AC, Castillo PF. Minimal surgical access to treat gynecomastia with the use of a powerassisted arthroscopic-endoscopic cartilage shaver. Plast Reconstr Surg [Internet]. Mar 2005;115(3):939-42.

  15. Reza-Taheri A, Reza-Farahvash M, Reza-Fathi H, Ghanbarzadeh K, Faridniya B. The satisfaction rate among patients and surgeons after periareolar surgical approach to gynecomastia along with liposuction. World J Plast Surg [Internet]. Sep 2016 [citado 12 Ene 2017];5(3):287-92. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5109391/pdf/wjps-5-287.pdf

  16. Arvind A, Abbas-Khan MA, Srinivasan K, Roberts J. Gynaecomastia correction: a review of our experience. Indian J Plast Surg [Internet]. Abr 2014 [citado 12 En 2017];47(1):56-60. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4075218/

  17. Mishra RK. Trans-nipple removal of fibro-glandular tissue in gynaecomastia surgery without additional scars: An innovative approach. Indian J Plast Surg. [Internet]. Abr 2014 [citado 12 Ene 2017];47(1):50-5. Disponible en: https://www.researchgate.net/profile/R_K_Mishra2/publication/263709951_Transnipple_ removal_of_fibroglandular_ tissue_in_gynaecomastia_surgery_without_additional_scars_An_innovative_approach/links/ 5698d7f108ae34f3cf2071a7/Trans-nipple-removal-of-fibro-glandular-tissue-in-gynaecomastia-surgerywithout- additional-scars-An-innovative-approach.pdf

  18. Borbón-Mendoza J, Beato-Canfux A, Álvarez-Ross A. Tratamiento quirúrgico de la ginecomastia y ptosis mamaria con técnica novedosa. Rev Cub Med Mil [Internet]. Dic 1997 [citado 12 Ene 2017];26(2):141-5. Disponible en: http://scielo.sld.cu/scielo.php?pid=S0138-65571997000200009&script=sci_arttext&tlng=pt




2020     |     www.medigraphic.com