El Wakeel, H., Abou Arab, M., Kholosy, H. (2021). Bodybuilder Gynecomastia: Etiology, Characteristics, and Management. The Egyptian Journal of Plastic and Reconstructive Surgery, 45(3), 133-139. doi: 10.21608/ejprs.2021.183853
Helmy El Wakeel; Mohamed H. Abou Arab; Hassan M. Kholosy. "Bodybuilder Gynecomastia: Etiology, Characteristics, and Management". The Egyptian Journal of Plastic and Reconstructive Surgery, 45, 3, 2021, 133-139. doi: 10.21608/ejprs.2021.183853
El Wakeel, H., Abou Arab, M., Kholosy, H. (2021). 'Bodybuilder Gynecomastia: Etiology, Characteristics, and Management', The Egyptian Journal of Plastic and Reconstructive Surgery, 45(3), pp. 133-139. doi: 10.21608/ejprs.2021.183853
El Wakeel, H., Abou Arab, M., Kholosy, H. Bodybuilder Gynecomastia: Etiology, Characteristics, and Management. The Egyptian Journal of Plastic and Reconstructive Surgery, 2021; 45(3): 133-139. doi: 10.21608/ejprs.2021.183853
Bodybuilder Gynecomastia: Etiology, Characteristics, and Management
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.
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