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Plastic Surgery( Grabb)Ali jasim > Gynecomastia > Flashcards

Gynecomastia Flashcards

1
Q

Causes of Neonatal mastauxe

A

is directly correlated to circulating maternal estrogens, and
is seen in almost 70% of infants

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2
Q

A small breast bud of l to 2 cm is
often palpable in the newborn

A

T

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3
Q

As maternal estrogen levels fall, some
neonates experience a surge of prolactin, which may cause the temporary secretion of milk

A

T

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4
Q

during puberty the percentage of transient gynecomastia during this period of development

A

Up to 65% of adolescent
boys experience transient gynecomastia

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5
Q

An elevated ratio of circulating estradiol to testosterone
during puberty is thought to be causative

A

T with an onset between
the ages of 10 and 13 years

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6
Q

The percentage of males who have persistent gynecomastia beyond the puberty period?

A

Approximately 4% of males will have
persistent gynecomastia beyond this period
defined by breast bud enlargement of greater than 4 cm

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7
Q

senile gynecomastia cause?

A

attributed to decreases in testosterone and
an increase in adipose tissue, leading to the peripheral conversion
of androgens to estrogens

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8
Q

this imbalance of hormones
leads to breast enlargement that affects up to 65% ofmen

A

T

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9
Q

Nucleoside reverse transcriptase inhibitors can cause gynecomastia

A

T

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10
Q

softening and dissipation of the glandular breast enlargement should be seen within
1 month of discontinuation of the offending agent

A

T

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11
Q

The breast bud beneath the nipple areolar
the complex is often painless to the patient with
idiopathic gynecomastia

A

F is often tender to the patient with
idiopathic gynecomastia

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12
Q

breast cancer must always remain on the differential
diagnosis when examining breast enlargement in male patients

A

T

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13
Q

In patients with Klinefelter syndrome, their risk of
developing breast cancer is almost 60 times greater than the general
male population,

A

T excisional surgical techniques are preferred in
this high-risk population.

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14
Q

all of these classification systems focus on the degree of breast enlargement as well as
the skin redundancy and nipple ptosis

A

T

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15
Q

Nonsurgical management of gynecomastia should be explored first

A

T

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16
Q

Percentage of patients whom response to tamoxifen

A

complete resolution of gynecomastia in 83.3% of their
patients treated with tamoxifen

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17
Q

tamoxifen is not
yet approved by the Food and Drug Administration as a treatment
for gynecomastia

A

T

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18
Q

Clomiphene citrate significantly improves the outcome of gynecomastia

A

Clomiphene citrate has also been trialed in small
studies, with minimal improvement in the adolescent population

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19
Q

Patients with prostate cancer treated with bicalutamide monotherapy commonly experience gynecomastia and mastodynia how you can treat them ?

A

receive off-label prophylactic or therapeutic treatment
with tamoxifen or anastrazole, an aromatase inhibitor, with varying
levels of efficacy or Prophylactic radiotherapy

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20
Q

when we can strat the surgical treatment for gynecomastia?

A

If exogenous causes are controlled and the patient’s gynecomastia
persists for at least 1 year, surgical treatment is warranted

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21
Q

Suction-assisted lipectomy is an excellent option for patients with
minimal to moderate tissue and skin excess

A

T

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22
Q

The use of ultrasound-assisted liposuction has broadened the
indications for liposuction, as it is able to address the firmer glandular breast tissue under the nipple areolar complex.

A

T

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23
Q

The IMF should be preserve in patient with gynicomastia

A

The surgeon
should intentionally disrupt the inframammary fold, because such
dermoglandular attachment is feminizing

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24
Q

the
lower pole may be contoured via liposuction to emphasize the inferior border of the pectoralis major muscle and create more masculine
definition

A

T

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25
Q

In patients with moderate glandular excess as well as moderate
skin excess it is advisable to stage skin excision by performing liposuction or direct glandular excision first.

A

T

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26
Q

If there is good skin elasticity, the loose skin envelope will contract following surgery

A

T

27
Q

In older
individuals or those with poor elasticity, a second procedure may be
necessary to trim the excess skin and improve shape. A period of at
least 6 to 12 months postoperatively allows the tissue to retract

A

T

28
Q

the amount of skin removed is far less than if it had been
completed at the initial surgery.

A

T

29
Q

For patients with minimal to moderate excess that is predominantly glandular, liposuction and then stage skin excision

A

F For patients with minimal to moderate excess that is predominantly glandular, a direct excision technique is preferred

30
Q

A limited
periareolar incision offers access to the parenchyma for direct excision and creates a well-concealed scar

A

T

31
Q

periareolar incision
may be extended laterally onto the breast skin in an omega pattern
to gain better access to the breast.

A

T

32
Q

It is imperative that a mound of at least
1.5 cm of gland be left below the nipple areolar complex to prevent
over resection and a concavity below the nipple

A

T

33
Q

In case of large areola A circumareolar mastopexy pattern may be performed with deepithelialization to reduce the diameter of the areola and possibly skin envelop

A

T

34
Q

Patients with moderate to severe enlargement and skin excess
require excisional techniques that address both the glandular and
skin redundancy.

A

T

35
Q

The nipple can also be preserved on a dermal
pedicle to reduce bulk

A

T

36
Q

Patients should
be well informed of the consequences of free nipple grafting, including graft loss, sensory changes, pigment loss, and asymmetry

A

T

37
Q

If the nipple lies at or slightly below the fold, veritcal excision may be sufficient to remove the skin excess

A

F If the nipple lies at or slightly below the fold, a periareolar excision may be sufficient to remove the skin excess

38
Q

Unlike the female breast,
the nipple should be placed inferior and lateral at the level of the
inferior border ofthe pectoralis muscle.

A

t

39
Q

ideal sternal notch to nipple distance in male

A

ideal sternal notch to nipple distance to be 20 cm, with 21 cm between
each nipple.

40
Q

The average diameter of a male nipple

A

2.8 cm

41
Q

In postbariatric patients, surgical tech with a boomerang-patterned excision

A

T

42
Q

The cause of breast enlargement in Bodybuilders is because of excess fat

A

F In bodybuilders, the gynecomastia is usually glandular and fibrotic, as these patients have a paucity of body fat

43
Q

The option of chouse for bodybuilder is liposuction

A

F minimally invasive techniques such as liposuction are less effective in these patients.
Direct excision of the enlarged gland via a pullthrough technique is often indicated.

44
Q

Pseudogynecomastia refers to enlargement of the male breast
in the morbidly obese

A

T

45
Q

Suction drains should be considered in patients after
direct excision, or when there is significant dead space present

A

T

46
Q

The patients should continue
compression for how long?

A

for up to 3 months postoperatively throughout the
healing process to reduce postoperative edema and ensure a flat
contour

47
Q

Patients with direct excision via a limited incision are the most likely
to experience hematoma, why?

A

T as the visibility with this technique may be
poor, leading to postoperative bleeding complications

48
Q

Complications of surgical intervention

A

include under resection, over resection, contour irregularity, and asymmetry. Patients
may also experience hematomas, seromas, scarring, and infection

49
Q

Within the first month of life, hormones
normalize, and these self-limiting symptoms dissipate

A

T

50
Q

The second peak in gynecomastia is seen during puberty, and
can last for a period of months to years.

A

T

51
Q

Medications and illicit drugs are the most common causes of
gynecomastia in men

A

T

52
Q

skin elasticity, and the size and shape of the nipple-areolar complex, is accounted
in Simon classification system.

A

f skin elasticity, and the
size and shape of the nipple-areolar complex, are not accounted
for in this classification system.

53
Q

For those with pseudo gynecomastia,
weight loss is an effective strategy to reduce the amount of adipose
tissue and help improve the contour of the chest

A

T

54
Q

decrease in breast tenderness for 84% of men during treatment with tamoxifen

A

T

55
Q

Prophylactic radiotherapy has also been found to be effective at mitigating approximately one third of the gynecomastia and mastodynia
seen with bicalutamide therapy.

A

T

56
Q

Placing the incision along the
inferior lateral aspect of the areola further shadows the incision and
leads to a minimally perceptible scar

A

T

57
Q

When
the nipple is more ptotic and there is marked tissue excess, a reduction mammoplasty approach is necessary

A

T

58
Q

The skin is excised in a vertical pattern, wise pattern, or in a total amputation technique with an
inframammary scar only in sever ptosis grade iii

A

T

59
Q

nipple can also be preserved on a dermal
pedicle to reduce bulk; however, the blood supply is less reliable with
such a technique.

A

T

60
Q

the new nipple should be located at
0.722 of the patient’s height. At that level, chest circumference is then
measured, and the distance between the nipple areolar complexes
should be 0.213 of the circumference.

A

T

61
Q

In the postbariatric patients a successful
technique with a boomerang-patterned excision in these patients

A

T

62
Q

boomerang-patterned

A

the ptotic nipple areolar complex is relocated,
while simultaneously excising breast and torso laxity in the patient.
This pattern may then be extended laterally to remove lateral tissue
excess on the male chest and axilla.

63
Q

When ultrasound-assisted liposuction is used, contact burns may occur, especially at the port entry site when moist towels are not used to protect
the skin

A

T

Plastic Surgery( Grabb)Ali jasim (92 decks)

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