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Risk Factors For Seroma/Hematoma Development Following Surgical Repair Of Adolescent Gynecomastia
Catherine T. McNamara, BS, Laura C. Nuzzi, BA, Joseph M. Firriolo, MD, Landis R. Walsh, BA, Gabrielle G. Massey, Shannon M. Malloy, BS, Brian I. Labow, MD.
Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.

PURPOSE: Seroma/hematoma formation following surgical correction of gynecomastia (male breast gland hypertrophy) is common. However, there are currently no data detailing the risk factors for developing a hematoma/seroma following surgical repair of gynecomastia. This study aims to reveal risk factors associated with postoperative development of a seroma/hematoma in adolescent gynecomastia patients.
METHODS: Demographic information, procedure type, and early (≤1 month) postoperative seroma/hematoma formation were collected from clinical outcomes forms and hospital medical records for patients 12-21 years of age undergoing surgical correction of unilateral or bilateral gynecomastia.
RESULTS: A total of 135 breasts from 72 male patients (mean age at surgery: 16.9 1.8 years) were included in the study. Bilateral and unilateral gynecomastia were diagnosed in 63 and 9 patients, respectively. Seromas/hematomas were reported in 20% of breasts, and there was a significant association between undergoing suction lipectomy and developing a postoperative seroma/hematoma (p<0.05). Breasts that received suction lipectomy were 63.2% less likely to develop a postoperative seroma/hematoma compared to all other patients. Ethnicity, age, BMI category, and all other procedure types (reduction mammaplasty; mastopexy; simple mastectomy for gynecomastia, and breast mass excision) were not significantly associated with seroma/hematoma development (p> 0.05, all).
CONCLUSIONS: Although seroma/hematoma formation is common following gynecomastia repair, patient characteristics, such as BMI category, ethnicity, and age, were not significant predictors of seroma/hematoma development in our cohort. These data propose that demographics should not preclude adolescent males from receiving surgical treatment for gynecomastia repair due to fear of developing a seroma/hematoma. Our findings also suggest that the use of suction lipectomy may offer protection against seroma/hematoma development, however more research is needed to confirm.


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