The Effect of Surgical Treatment for Gynecomastia on Quality of Life in Adolescents

Laura C Nuzzi; Joseph M Firriolo; Carolyn M Pike; Felecia E Cerrato; Amy D DiVasta; Brian I Labow

doi:10.1016/j.jadohealth.2018.06.028

The Effect of Surgical Treatment for Gynecomastia on Quality of Life in Adolescents

J Adolesc Health. 2018 Dec;63(6):759-765. doi: 10.1016/j.jadohealth.2018.06.028. Epub 2018 Sep 29.

Authors

Laura C Nuzzi¹, Joseph M Firriolo¹, Carolyn M Pike¹, Felecia E Cerrato¹, Amy D DiVasta², Brian I Labow³

Affiliations

¹ Adolescent Breast Clinic, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
² Adolescent Breast Clinic, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
³ Adolescent Breast Clinic, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts. Electronic address: brian.labow@childrens.harvard.edu.

PMID: 30279103
DOI: 10.1016/j.jadohealth.2018.06.028

Abstract

Purpose: Despite the psychosocial deficits associated with gynecomastia, surgical treatment of adolescent gynecomastia remains controversial. This longitudinal cohort study measures changes in health-related quality of life following surgical treatment of gynecomastia in adolescents.

Methods: The following surveys were administered to adolescents with gynecomastia and male controls, aged 12-21 years: Short-Form 36v2 (SF-36), Rosenberg Self-Esteem Scale (RSES), and Eating-Attitudes Test-26. Subjects completed surveys at baseline and postoperatively/at follow-up at 6 months, 1 year, 3 years, and 5 years.

Results: From 2008 to 2017, 44 patients undergoing surgical treatment of gynecomastia and 64 unaffected male controls participated in our study. At baseline, gynecomastia patients scored significantly worse than controls on the RSES and in five SF-36 domains: general health, vitality, social functioning, role-emotional, and mental health. Scores significantly improved postoperatively on the RSES, and in four SF-36 domains: physical functioning, role-physical, bodily pain, and social functioning. Postoperatively, gynecomastia subjects scored similarly to controls in all SF-36 domains and the RSES. Young and overweight/obese patients and those with severe gynecomastia had the greatest postoperative improvement across survey measures.

Conclusions: Surgical treatment of gynecomastia significantly improves the quality of life of adolescents, with measurable improvements in physical and psychosocial functioning. Postoperatively, gynecomastia patients performed comparably to unaffected controls. Surgical treatment of gynecomastia in adolescents and young men has the potential to significantly improve quality of life, particularly in younger and overweight/obese patients and those with moderate to severe gynecomastia. Concerns regarding patient age and body mass index alone should not contraindicate surgery.

Keywords: Adolescent; Gynecomastia; Plastic surgery; Quality of life.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Body Mass Index
Gynecomastia / surgery*
Humans
Longitudinal Studies
Male
Postoperative Period
Prospective Studies
Quality of Life / psychology*
Surveys and Questionnaires