Surgical Management for Gynecomastia and Passot Technique

Abstract

Gynecomastia, defined as the benign proliferation of glandular breast tissue in males, is a common condition that can affect adolescents, adults, and elderly men. While mild cases may resolve spontaneously or respond to medical management, persistent or advanced forms often require surgical correction. The goals of surgery include removal of excess glandular tissue and fat, correction of skin redundancy, and restoration of a masculine chest contour. Several surgical techniques have been described, including liposuction, subcutaneous mastectomy, and combined approaches. The choice depends on the grade of gynecomastia, skin quality, and degree of ptosis. The Passot technique, originally described for female breast reduction, has been adapted for severe gynecomastia cases with significant skin excess. It provides effective tissue excision while repositioning the nipple–areola complex, minimizing visible scars, and improving aesthetic outcomes.