Cleveland Clinic Abu Dhabi pioneers reconstructive technique to improve surgical outcomes for patients with gynecomastia

• Novel technique improves appearance and overall outcome of breast tissue excision surgery • Gynecomastia is a common male concern that adversely affects patients’ self-image • Every gynecomastia patient is also screened for breast cancer, vital organ function and hormonal imbalances at Cleveland Clinic Abu Dhabi

Experts at Cleveland Clinic Abu Dhabi, part of the M42 network, have pioneered a new reconstructive procedure to innovatively enhance the surgical outcomes of gynecomastia, a common male concern across the world.

Gynecomastia is the enlargement of breast tissue in males. The novel procedure developed by Cleveland Clinic Abu Dhabi improves body contouring and surgical outcomes for patients who have opted for surgical removal of the enlarged breast tissue, thereby supporting patient well-being.

To treat gynecomastia, patients undergo surgery, during which physicians remove excess breast tissue and skin, perform liposuction, and reposition the nipple areola complex to a more natural position. The removal of the tissue, however, often causes a concave dip in the chest, known as a ‘dished-out appearance’, and can hamper the patient’s self-image and overall post-surgical outcomes. The innovative technique conceptualized and performed by Dr. Iskanderian involves utilization of the thickened and anomalous inframammary fold that forms under enlarged breasts to augment the pectoralis muscle, the largest muscle in the chest wall, thereby preventing the undesirable dished-out appearance after this radical surgery.

Dr. Rafal Iskanderian, Staff Physician in the Comprehensive Breast Cancer Program at Cleveland Clinic Abu Dhabi, explained the importance of the innovation “Traditionally, the anomalous inframammary fold is carefully resected and disposed, but this can create an abnormal torso image. Our novel technique seeks to avoid the undesired appearance that may result from gynecomastia corrective surgery, and can significantly enable young men opting for the procedure to become confident in their own skin. We have carried out the procedure on 30 patients, and the results are extremely promising and well-received”.

Gynecomastia, which is caused by hormonal imbalances, steroid or medication use, obesity, or organ malfunction, is believed to affect up to half of all healthy men around the world. If the condition does not resolve itself within six months, or disrupts an individual’s self-confidence, surgical intervention is the prescribed course of action.

There is growing awareness about gynecomastia, with the condition reported by 30% of patients seeking care through Cleveland Clinic Abu Dhabi’s Breast Health Program.

Cleveland Clinic Abu Dhabi treats about 100 cases of gynecomastia each year. While the condition is itself not a risk factor for breast cancer, every patient is initially screened through imaging, and even biopsies if required, to ensure that the enlarged breast tissue is not malignant. This is crucial since 0.5-1% of breast cancer patients around the world are men.

The Breast Health Program at Cleveland Clinic Abu Dhabi provides a thorough clinical assessment for men with gynecomastia, utilizing a comprehensive approach encompassing history, examination, complete blood workup, and imaging tests. This integrated process aims to accurately diagnose hormonal imbalances and rule out potential malignancies associated with gynecomastia.