{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T19:52:11Z","timestamp":1792180331845,"version":"4.4.0"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Aesth Plast Surg"],"DOI":"10.1007\/s00266-026-06379-w","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T19:16:04Z","timestamp":1792178164000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Clinical Algorithm for Gynecomastia: From Diagnosis to Surgical Management"],"prefix":"10.1007","author":[{"given":"Jung-Eun","family":"Moon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seok Gi","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jongmoo","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Sok","family":"Ha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon Suk","family":"Moon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byeongju","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeeyeon","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho Yong","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Yeop","family":"Ryu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang Young","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Dug","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho Yun","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1580-0487","authenticated-orcid":false,"given":"Joon Seok","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"issue":"2","key":"6379_CR1","doi-asserted-by":"publisher","first-page":"150","DOI":"10.4103\/2230-8210.129104","volume":"18","author":"N Cuhaci","year":"2014","unstructured":"Cuhaci N, Polat SB, Evranos B, Ersoy R, Cakir B. Gynecomastia: clinical evaluation and management. Indian J Endocrinol Metab. 2014;18(2):150\u20138.","journal-title":"Indian J Endocrinol Metab"},{"issue":"7646","key":"6379_CR2","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1136\/bmj.39511.493391.BE","volume":"336","author":"CB Niewoehner","year":"2008","unstructured":"Niewoehner CB, Schorer AE. Gynaecomastia and breast cancer in men. BMJ. 2008;336(7646):709\u201313.","journal-title":"BMJ"},{"issue":"11","key":"6379_CR3","doi-asserted-by":"publisher","first-page":"1010","DOI":"10.1016\/S0025-6196(11)60671-X","volume":"84","author":"RE Johnson","year":"2009","unstructured":"Johnson RE, Murad MH. Gynecomastia: pathophysiology, evaluation, and management. Mayo Clin Proc. 2009;84(11):1010\u20135.","journal-title":"Mayo Clin Proc"},{"issue":"2","key":"6379_CR4","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1210\/jcem-48-2-338","volume":"48","author":"FQ Nuttall","year":"1979","unstructured":"Nuttall FQ. Gynecomastia as a physical finding in normal men. J Clin Endocrinol Metab. 1979;48(2):338\u201340.","journal-title":"J Clin Endocrinol Metab"},{"issue":"11","key":"6379_CR5","doi-asserted-by":"publisher","first-page":"684","DOI":"10.1038\/nrendo.2014.139","volume":"10","author":"HS Narula","year":"2014","unstructured":"Narula HS, Carlson HE. Gynaecomastia: pathophysiology, diagnosis and treatment. Nat Rev Endocrinol. 2014;10(11):684\u201398.","journal-title":"Nat Rev Endocrinol"},{"issue":"12","key":"6379_CR6","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1002\/phar.1138","volume":"32","author":"JD Bowman","year":"2012","unstructured":"Bowman JD, Kim H, Bustamante JJ. Drug-induced gynecomastia. Pharmacotherapy. 2012;32(12):1123\u201340.","journal-title":"Pharmacotherapy"},{"issue":"5","key":"6379_CR7","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1517\/14740338.2012.712109","volume":"11","author":"F Deepinder","year":"2012","unstructured":"Deepinder F, Braunstein GD. Drug-induced gynecomastia: an evidence-based review. Expert Opin Drug Saf. 2012;11(5):779\u201395.","journal-title":"Expert Opin Drug Saf"},{"issue":"1","key":"6379_CR8","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.bjps.2007.09.033","volume":"61","author":"A Cordova","year":"2008","unstructured":"Cordova A, Moschella F. Algorithm for clinical evaluation and surgical treatment of gynaecomastia. J Plast Reconstr Aesthet Surg. 2008;61(1):41\u20139.","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"6","key":"6379_CR9","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1111\/andr.12636","volume":"7","author":"GA Kanakis","year":"2019","unstructured":"Kanakis GA, Nordkap L, Bang AK, et al. EAA clinical practice guidelines: gynecomastia evaluation and management. Andrology. 2019;7(6):778\u201393.","journal-title":"Andrology"},{"issue":"1","key":"6379_CR10","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1097\/00006534-197301000-00009","volume":"51","author":"BE Simon","year":"1973","unstructured":"Simon BE, Hoffman S, Kahn S. Classification and surgical correction of gynecomastia. Plast Reconstr Surg. 1973;51(1):48\u201352.","journal-title":"Plast Reconstr Surg"},{"issue":"2","key":"6379_CR11","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1097\/01.PRS.0000042146.40379.25","volume":"111","author":"RJ Rohrich","year":"2003","unstructured":"Rohrich RJ, Ha RY, Kenkel JM, Adams WP Jr. Classification and management of gynecomastia: defining the role of ultrasound-assisted liposuction. Plast Reconstr Surg. 2003;111(2):909\u201323.","journal-title":"Plast Reconstr Surg"},{"issue":"8","key":"6379_CR12","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1093\/asj\/sjaf069","volume":"45","author":"A Wolter","year":"2025","unstructured":"Wolter A, Fertsch SM, Daniels M, et al. Innovative surgical concept for Simon\u2019s grade IIb gynecomastia: a systematic integration of circumareolar mastectomy, interlocking suture, inframammary fold detachment, and waterjet-assisted liposuction for superior long-term outcomes. Aesthet Surg J. 2025;45(8):786\u201398.","journal-title":"Aesthet Surg J"},{"issue":"20","key":"6379_CR13","doi-asserted-by":"publisher","first-page":"2191","DOI":"10.1001\/jama.2013.281053","volume":"310","author":"World Medical Association","year":"2013","unstructured":"World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191\u20134.","journal-title":"JAMA"},{"issue":"2","key":"6379_CR14","first-page":"204","volume":"88","author":"AT Soliman","year":"2017","unstructured":"Soliman AT, De Sanctis V, Yassin M. Management of adolescent gynecomastia: an update. Acta Biomed. 2017;88(2):204\u201313.","journal-title":"Acta Biomed"},{"key":"6379_CR15","doi-asserted-by":"publisher","first-page":"1367550","DOI":"10.3389\/fped.2024.1367550","volume":"12","author":"O Berger","year":"2024","unstructured":"Berger O, Hornik-Lurie T, Talisman R. Pubertal gynecomastia incidence among 530,000 boys: a cross sectional population based study. Front Pediatr. 2024;12:1367550.","journal-title":"Front Pediatr"},{"issue":"7","key":"6379_CR16","first-page":"716","volume":"85","author":"G Dickson","year":"2012","unstructured":"Dickson G. Gynecomastia. Am Fam Physician. 2012;85(7):716\u201322.","journal-title":"Am Fam Physician"},{"issue":"1","key":"6379_CR17","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1186\/s12887-019-1887-7","volume":"19","author":"JE Moon","year":"2019","unstructured":"Moon JE, Ko CW, Yang JD, Lee JS. Combined surgical and medical treatment in an adolescent with severe gynecomastia due to excessive estradiol secretion: a case report. BMC Pediatr. 2019;19(1):515.","journal-title":"BMC Pediatr"},{"issue":"2","key":"6379_CR18","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1148\/rg.332125208","volume":"33","author":"GE Lattin Jr","year":"2013","unstructured":"Lattin GE Jr, Jesinger RA, Mattu R, Glassman LM. From the radiologic pathology archives: diseases of the male breast: radiologic-pathologic correlation. Radiographics. 2013;33(2):461\u201389.","journal-title":"Radiographics"},{"issue":"6","key":"6379_CR19","doi-asserted-by":"publisher","first-page":"748","DOI":"10.5999\/aps.2014.41.6.748","volume":"41","author":"BH Lee","year":"2014","unstructured":"Lee BH, Kwon YJ, Park JW, Hwang JH, Kim KS, Lee SY. Gynecomastia surgery is associated with improved nipple location in young Korean patients. Arch Plast Surg. 2014;41(6):748\u201352.","journal-title":"Arch Plast Surg"},{"issue":"8","key":"6379_CR20","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0136094","volume":"10","author":"A Fagerlund","year":"2015","unstructured":"Fagerlund A, Cormio L, Palangi L, et al. Gynecomastia in patients with prostate cancer: a systematic review. PLoS ONE. 2015;10(8):e0136094.","journal-title":"PLoS ONE"},{"key":"6379_CR21","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.euros.2025.01.001","volume":"73","author":"I Tsuboi","year":"2025","unstructured":"Tsuboi I, Schulz RJ, Laukhtina E, et al. Incidence, management, and prevention of gynecomastia and breast pain in patients with prostate cancer undergoing antiandrogen therapy: a systematic review and meta-analysis of randomized controlled trials. Eur Urol Open Sci. 2025;73:31\u201342.","journal-title":"Eur Urol Open Sci"},{"issue":"8","key":"6379_CR22","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1111\/j.1524-6175.2004.3735.x","volume":"6","author":"A Mosenkis","year":"2004","unstructured":"Mosenkis A, Townsend RR. Gynecomastia and antihypertensive therapy. J Clin Hypertens. 2004;6(8):469\u201370.","journal-title":"J Clin Hypertens"},{"key":"6379_CR23","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-10-96","volume":"10","author":"F Kunath","year":"2012","unstructured":"Kunath F, Keck B, Antes G, Wullich B, Meerpohl JJ. Tamoxifen for the management of breast events induced by non-steroidal antiandrogens in patients with prostate cancer: a systematic review. BMC Med. 2012;10:96.","journal-title":"BMC Med"},{"issue":"12","key":"6379_CR24","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.1056\/NEJMcp070677","volume":"357","author":"GD Braunstein","year":"2007","unstructured":"Braunstein GD. Gynecomastia. N Engl J Med. 2007;357(12):1229\u201337.","journal-title":"N Engl J Med"},{"issue":"10","key":"6379_CR25","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1056\/NEJM199909023411001","volume":"341","author":"B Pitt","year":"1999","unstructured":"Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone evaluation study investigators. N Engl J Med. 1999;341(10):709\u201317.","journal-title":"N Engl J Med"},{"issue":"3","key":"6379_CR26","doi-asserted-by":"publisher","first-page":"638e","DOI":"10.1097\/PRS.0000000000003059","volume":"139","author":"D Waltho","year":"2017","unstructured":"Waltho D, Hatchell A, Thoma A. Gynecomastia classification for surgical management: a systematic review and novel classification system. Plast Reconstr Surg. 2017;139(3):638e\u201348e.","journal-title":"Plast Reconstr Surg"},{"issue":"4","key":"6379_CR27","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1097\/PRS.0b013e3182818ea8","volume":"131","author":"LC Nuzzi","year":"2013","unstructured":"Nuzzi LC, Cerrato FE, Erickson CR, et al. Psychosocial impact of adolescent gynecomastia: a prospective case-control study. Plast Reconstr Surg. 2013;131(4):890\u20136.","journal-title":"Plast Reconstr Surg"},{"issue":"Suppl 1","key":"6379_CR28","doi-asserted-by":"publisher","first-page":"S70","DOI":"10.21037\/gs.2018.03.09","volume":"7","author":"M Sollie","year":"2018","unstructured":"Sollie M. Management of gynecomastia: changes in psychological aspects after surgery, a systematic review. Gland Surg. 2018;7(Suppl 1):S70\u20136.","journal-title":"Gland Surg"},{"key":"6379_CR29","doi-asserted-by":"publisher","DOI":"10.1177\/22925503241249753","author":"M Karpinski","year":"2024","unstructured":"Karpinski M, Tuen YJ, Courtemanche R, Arneja JS. Quality of life measured using the BODY-Q after adolescent gynecomastia surgery: a cross-sectional analysis. Plast Surg. 2024. https:\/\/doi.org\/10.1177\/22925503241249753.","journal-title":"Plast Surg"},{"issue":"7","key":"6379_CR30","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1056\/NEJM199302183280708","volume":"328","author":"GD Braunstein","year":"1993","unstructured":"Braunstein GD. Gynecomastia. N Engl J Med. 1993;328(7):490\u20135.","journal-title":"N Engl J Med"},{"key":"6379_CR31","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1001\/jama.1961.03040440001001","volume":"178","author":"M Nydick","year":"1961","unstructured":"Nydick M, Bustos J, Dale JH Jr, Rawson RW. Gynecomastia in adolescent boys. JAMA. 1961;178:449\u201354.","journal-title":"JAMA"},{"issue":"16","key":"6379_CR32","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1093\/jnci\/dji240","volume":"97","author":"AJ Swerdlow","year":"2005","unstructured":"Swerdlow AJ, Schoemaker MJ, Higgins CD, Wright AF, Jacobs PA. Cancer incidence and mortality in men with Klinefelter syndrome: a cohort study. J Natl Cancer Inst. 2005;97(16):1204\u201310.","journal-title":"J Natl Cancer Inst"},{"key":"6379_CR33","doi-asserted-by":"publisher","DOI":"10.3389\/frph.2021.629673","volume":"3","author":"A Abdel Raheem","year":"2021","unstructured":"Abdel Raheem A, Zaghloul AS, Sadek AMG, Rayes B, Abdel-Raheem TM. The impact and management of gynaecomastia in Klinefelter syndrome. Front Reprod Health. 2021;3:629673.","journal-title":"Front Reprod Health"},{"issue":"2","key":"6379_CR34","doi-asserted-by":"publisher","first-page":"75","DOI":"10.6065\/apem.2346142.071","volume":"29","author":"KA Metwalley","year":"2024","unstructured":"Metwalley KA, Farghaly HS. Gynecomastia in adolescent males: current understanding of its etiology, pathophysiology, diagnosis, and treatment. Ann Pediatr Endocrinol Metab. 2024;29(2):75\u201381.","journal-title":"Ann Pediatr Endocrinol Metab"},{"issue":"9","key":"6379_CR35","doi-asserted-by":"publisher","first-page":"4428","DOI":"10.1210\/jc.2004-0082","volume":"89","author":"PV Plourde","year":"2004","unstructured":"Plourde PV, Reiter EO, Jou HC, et al. Safety and efficacy of anastrozole for the treatment of pubertal gynecomastia: a randomized, double-blind, placebo-controlled trial. J Clin Endocrinol Metab. 2004;89(9):4428\u201333.","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"6379_CR36","doi-asserted-by":"publisher","first-page":"27","DOI":"10.7570\/jomes24012","volume":"33","author":"SM Jeong","year":"2023","unstructured":"Jeong SM, Jung JH, Yang YS, et al. 2023 Obesity Fact Sheet: prevalence of obesity and abdominal obesity in adults, adolescents, and children in Korea from 2012 to 2021. J Obes Metab Syndr. 2023;33(1):27\u201335.","journal-title":"J Obes Metab Syndr"},{"key":"6379_CR37","first-page":"1","volume":"158","author":"B Stierman","year":"2021","unstructured":"Stierman B, Afful J, Carroll MD, et al. National health and nutrition examination survey 2017\u2013March 2020 prepandemic data files: development of files and prevalence estimates for selected health outcomes. Natl Health Stat Report. 2021;158:1\u201320.","journal-title":"Natl Health Stat Report"},{"key":"6379_CR38","volume-title":"2023 Plastic Surgery Statistics Report","author":"American Society of Plastic Surgeons","year":"2024","unstructured":"American Society of Plastic Surgeons. 2023 plastic surgery statistics report. Arlington Heights, IL: American Society of Plastic Surgeons; 2024."}],"container-title":["Aesthetic Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00266-026-06379-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00266-026-06379-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00266-026-06379-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T19:16:05Z","timestamp":1792178165000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00266-026-06379-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,16]]},"references-count":38,"alternative-id":["6379"],"URL":"https:\/\/doi.org\/10.1007\/s00266-026-06379-w","relation":{},"ISSN":["0364-216X","1432-5241"],"issn-type":[{"value":"0364-216X","type":"print"},{"value":"1432-5241","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,16]]},"assertion":[{"value":"19 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare that they have no competing financial interests or personal relationships that could have appeared to influence the work reported in this manuscript. No part of this study was sponsored by industry. The corresponding author had full access to all data and final responsibility for the decision to submit for publication.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Institutional Review Boards of both participating hospitals (institutional review board approval numbers are provided on the separate title page), and the requirement for individual informed consent was waived owing to the retrospective design and the exclusive use of de-identified medical records. The study was conducted in accordance with the principles of the Declaration of Helsinki (2013 revision) [\n                      \n                      ]. For the representative case illustrations (Figs.\n                      \n                      ,\n                      \n                      ,\n                      \n                      ,\n                      \n                      ,\n                      \n                      and\n                      \n                      ), separate written informed consent for publication of clinical photographs was obtained from each patient or, in the case of the adolescent patient illustrated in Figs.\n                      \n                      ,\n                      \n                      and\n                      \n                      , from a parent\/legal guardian with patient assent.","order":2,"name":"Ethics","label":"Ethical Approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}