Q: I have a 14 year old boy with gynecomastia. It is hereditary. He is a thin boy but his chest is overdeveloped. If he has a liposuction done now, what are the chances he may need to do it again in the future?
A: The classic teaching in plastic surgery is to do gynecomastia surgery when growth is more complete. This is done with the concept in mind that there will be less chance of gynecomastia recurrence and the need for secondary surgery. While this does make sense from the perspective of decreasing the risk of further surgery, it does not take into account something that I think is more important…the psychosocial development of the young teenage male. Waiting until age 17 or 18 for gynecomastia surgery exposes the adolescent male to vital years of self-image development. For this reason, one should consider gynecomastia surgery when the problem clearly affects teenage behavior and a medical reason for the gynecomastia has been ruled out.
When undergoing early gynecomastia surgery, one accepts the trade-off that recurrence is more likely than when done at an older age. In my experience of doing gynecomastia surgery at age 14 or 15, however, I have not seen patients that have returned with recurrences. (although just because they have not returned does not mean that some have not had recurrences)
Dr. Barry Eppley