Gynecomastia classification: Difference between revisions
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==Overview== | ==Overview== | ||
Gynecomastia has been classified by various systems mainly based on surgical management, the severity of gynecomastia, physical appearance, and etiology. Breast size and ptosis are the most commonly included features. | Gynecomastia has been classified by various systems mainly based on surgical management, the severity of gynecomastia, physical appearance, and etiology. Breast size and ptosis are the most commonly included features. | ||
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* Type 3: Ptotic breasts with inelastic skin | * Type 3: Ptotic breasts with inelastic skin | ||
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|Webster | |||
|1946 | |||
|Tissue type | |||
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* Class 1: Periductal connective tissue hypertrophy without adipose tissue change | |||
* Class 2: Increase in the amount of both connective and adipose tissue | |||
* Class 3: Adipose tissue hypertrophy alone | |||
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===Classification based on severity=== | ===Classification based on severity=== |
Revision as of 19:14, 11 August 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Husnain Shaukat, M.D. Omodamola Aje B.Sc, M.D. [2]
Overview
Gynecomastia has been classified by various systems mainly based on surgical management, the severity of gynecomastia, physical appearance, and etiology. Breast size and ptosis are the most commonly included features.
Classification
Common features included in different gynecomastia classification systems included:[1][2][3]
- Breast size
- Skin redundancy
- Breast ptosis
- Tissue predominance
- Upper abdominal laxity
- Breast tuberosity
- Nipple malposition
- Chest shape
- Absence of sternal notch
- Breast skin elasticity
===Classification based on sugical management===[3]
Author | Year | Method of classification | Classification system |
---|---|---|---|
Nydick | 1961 | Physical appearance |
|
Tanner | 1971 | Physical appearance |
|
Simon | 1973 | Physical appearance |
|
Deutinger and Freilinger | 1986 | Physical appearance |
|
Cohen | 1987 | Physical appearance |
|
Rohrich | 2003 | Physical/Tissue type |
|
Gusenoff | 2008 | Physical |
|
Barros | 2012 | Physical |
|
Çi̇l | 2012 | Imaging (computed tomography | Gynecomastic adipose tissue/total gynecomastic tissue, <0.3 Gynecomastic adipose tissue/total gynecomastic tissue, 0.3–0.5 Gynecomastic adipose tissue/total gynecomastic tissue, >0.6 |
Cordova | 2008 | Physical |
|
Fruhstorfer | 2003 | Physical | Small-to-moderate Moderate-to-large |
Mladick | 2004 | Physical |
|
Monarca | 2013 | Physical/tissue type |
|
Ratnam | 2009 | Physical |
|
Webster | 1946 | Tissue type |
|
Classification based on severity
Gynecomastia can be graded on the basis of severity as:[4][5] [3]
- Grade I: Minor enlargement, no skin excess
- Grade II: Moderate enlargement, no skin excess
- Grade III: Moderate enlargement, skin excess
- Grade IV: Marked enlargement, skin excess
Classifcation based on pathogenesis
- Physiological
- Pathological
- Due to excess unopposed estrogen to androgen ratio.
References
- ↑ Waltho D, Hatchell A, Thoma A (2017). "Gynecomastia Classification for Surgical Management: A Systematic Review and Novel Classification System". Plast Reconstr Surg. 139 (3): 638e–648e. doi:10.1097/PRS.0000000000003059. PMID 28234829.
- ↑ Monarca C, Rizzo MI (2013). "Gynecomastia: tips and tricks-classification and surgical approach". Plast Reconstr Surg. 131 (5): 863e–5e. doi:10.1097/PRS.0b013e318287a18f. PMID 23629140.
- ↑ 3.0 3.1 3.2 Rohrich RJ, Ha RY, Kenkel JM, Adams WP (2003). "Classification and management of gynecomastia: defining the role of ultrasound-assisted liposuction". Plast Reconstr Surg. 111 (2): 909–23, discussion 924-5. doi:10.1097/01.PRS.0000042146.40379.25. PMID 12560721.
- ↑ Wollina, U; Goldman, A (June 2011). "Minimally invasive esthetic procedures of the male breast". Journal of cosmetic dermatology. 10 (2): 150–155. doi:10.1111/j.1473-2165.2011.00548.x. PMID 21649820.
- ↑ Simon BE, Hoffman S, Kahn S (1973). "Classification and surgical correction of gynecomastia". Plast Reconstr Surg. 51 (1): 48–52. PMID 4687568.