Management of gynecomastia-changes in psychological aspects after surgery-a systematic review.

Gynecomastia affects up to two-thirds of the male population. For many patients the psychological impact of the disease is substantial. Surgical treatment is indicated when medical treatments fail. Until now, most published research on the subject has focused on how effective surgical treatment is on correcting the cosmetic appearance of the breast. Little is known about the effect of surgical treatment on the psychological aspects of the disease. The aim of this review was to identify the psychological domains affected by the disease and the effect of surgical treatment on these. A systematic search of the published literature was performed. All studies on the subject were evaluated for inclusion and six studies were included in the review. Several of the included studies reported improvement in quality of life and several psychological domains after surgical treatment for gynecomastia. Among these domains, are; vitality, emotional discomfort, limitations due to physical aspects and limitations due to pain. Impact of surgical treatment for gynecomastia seems to be beneficial for several psychological domains. The current level of evidence on this subject is very low and future studies, examining the impact of the surgical intervention for gynecomastia on psychological domains, are greatly needed. More data on this subject could improve the pre-operative evaluation of these patients and help identify the patients that will benefit from treatment.