Clinical Characteristics and Surgical Outcomes of Adolescent Gynecomastia: A Retrospective Observational Study

<b>Introduction:</b> Adolescent gynecomastia is a common benign enlargement of male breast tissue that may cause significant psychosocial distress. Persistent cases often necessitate surgical intervention. This study aimed to evaluate clinical features, surgical techniques, outcomes, complications, and patient satisfaction in adolescents undergoing gynecomastia surgery at a single center. <br><br><b>Aim:</b> The present study was undertaken to retrospectively analyze the clinical characteristics, surgical techniques utilized, treatment outcomes, complications, and patient satisfaction following surgical management of gynecomastia in adolescent boys treated at a single surgical center for the macro-region of western Poland between 2000 and 2025. The study also aimed to identify factors associated with treatment results to improve and individualize patient care in this population. <br><br><b>Methods:</b> A retrospective observational study analyzed data from 26 boys aged 10-17 years who underwent surgical treatment for unilateral or bilateral gynecomastia between 2000 and 2025 at the Clinic of Pediatric Surgery, Traumatology, and Urology, Karol Jonscher Clinical Hospital, Poznan University of Medical Sciences. Surgical management primarily involved periareolar excision of glandular tissue, with selective liposuction or skin resection based on severity. Collected data included demographics, gynecomastia laterality, operative times, histopathology, complications, and patient satisfaction (5-point Likert scale). Statistical analyses included descriptive statistics, t-tests, Mann-Whitney U tests, chi-square tests, and Spearman correlation. <br><br><b>Results:</b> Bilateral gynecomastia was predominant (77%), with a median age at surgery of 16 years. Mean operative time was longer for bilateral procedures (58.5 min) than for unilateral ones (38.3 min). Histopathology confirmed benign glandular tissue in most cases. Postoperative complications were rare (11.5% hematomas; one transfusion), and no reoperations were required. Overall satisfaction was high (median 4/5), though older adolescents reported slightly lower satisfaction (Rs = -0.395, p = 0.046). <br><br><b>Conclusions:</b> Surgical management of adolescent gynecomastia is safe, effective, and associated with high patient satisfaction. Bilateral cases require longer operative times, but complication rates remain low. Individualized preoperative planning, including weight optimization and age-appropriate counseling, enhances cosmetic and psychosocial outcomes. These results support timely surgical intervention in adolescents with persistent gynecomastia causing aesthetic or psychological concerns.