Prevalence of Gynaecomastia in Male Pakistani Population

Gynaecomastia has an overall incidence of 32 to 40%.1 The highest prevalaence is found in old age and up to 65% in men.2 The breast tissue growth is dependent on the balance between the oestrogens and androgens; thus any physiological or pathological factor that can interfere with this balance, can result in gynaecomastia.2 Physiologically, it can be neonatal, pubertal or senile. Pathologically, it can occur in various diseases, e.g., hepatic disease, renal diseases, thyrotoxicosis,3 certain cancers like Sertoli cell tumour, bronchial carcinoma, lymphoma, gastric carcinoma,3 with the use of certain drugs, e.g., cimitidine, spironolactone, oestrogens, etc.3 Various pharmacological drugs have been tried but surgery remains the mainstay of the treatment.4 Gynaecomastia has a negative impact on self-confidence and body image.5 It should be distinguished from pesudogynaecomastia which is common in obese men and consists of lipomatesia without glandular proliferation.5 Treatment must be individualized while surgery is planned depending on the grade and histopathology of gynaecomastia.6 Liposuction is beneficial but patients presenting with larger enlargement, need skin retailoring surgery.7 The main objective of the following study was to present the demographic details and the operative measures for the patients presenting with gynaecomastia. All patients with gynaecomastia from January 2006 to December 2013 were included. A detailed history was taken with regard to the age of onset, duration of the enlargement, recent changes in the size, and any discharge. Any history of pain, alcohol intake or any other drugs was also noted. The patients presenting with lesion other than benign enlargement (cancer or abscess) were excluded from the study. All the patients were thoroughly examined. All the patients underwent routine laboratory tests and ultrasound check-up. Patients presenting with mild to moderate enlargement underwent Power-assisted liposuction (PAL). Patients presenting with severe enlargement and ptosis underwent excision as well as liposuction using nippleareola complex (NAC) repositioning and excision of the excess skin. The patients were followed-up for six months and any complication was noted. Totally, 77 patients were enrolled. The mean age of the patients was 31.5 years ranging from 18 to 46 years. All the patients had bilateral enlargement. Majority of the patients (48.1%) belonged to 25–35 years age group (<25 y: 18.2%; 36-45 y: 31.2% and >46 years: 2.5%). In majority of the patients (77.3%), the cause Plastic, Reconstructive, Hand and Hair Restorative Surgeon, La Chirurgie, Islamabad Cosmetic Surgery Centre, Islamabad, Pakistan