Redefining Gynecomastia Grading Using Anthropometric Parameters and Surgical Algorithm for Gynecomastia: A Single-center Study.
- 1From the Chennai Plastic Surgery, Chennai, Tamil Nadu, India.
- 2Department of Community Medicine, Government Medical College, Karur, Tamil Nadu, India.
Abstract
Background
Gynecomastia is a benign enlargement of male breast tissue. Traditional classifications, such as those by Simon and Rohrich, rely mainly on clinical judgment, leading to interobserver variability and surgical planning. A need exists for a measurable, reproducible objective grading method. This study proposes a gynecomastia classification system integrating anthropometric parameters such as nipple-to-pectoralis major distance and chest circumference difference. These objective measures aim to enhance grading reliability and surgical planning.Methods
A total of 134 patients who underwent gynecomastia correction between January and December 2024 were analyzed. Statistical analysis was performed using R software version 4.2. Receiver operating characteristic analysis determined the area under the curve, optimal cutoff points, and sensitivity and specificity.Results
In our modification, we assess severity using 2 objective measurements: the nipple-to-pectoralis major muscle distance and the difference in chest circumference between the nipple level and the inframammary fold. Grade 1 corresponds to a distance of less than 2 cm and a circumference difference of less than 3 inches; grade 2, 2-4 cm and 3-4 inches; grade 3, 4-6 cm and 4-6 inches; and grade 4, more than 6 cm and more than 6 inches. These parameters serve as indirect yet reliable indicators of skin redundancy and breast size.Conclusions
This grading system improves diagnostic accuracy and reproducibility in gynecomastia evaluation. It offers an objective, standardized framework that enhances communication and predictability of outcomes.
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BibTeX
@article{ramasamy2026redefining,
title = {{Redefining Gynecomastia Grading Using Anthropometric Parameters and Surgical Algorithm for Gynecomastia: A Single-center Study.}},
author = {Karthik Ramasamy and Mohammed Nishar Samiulla and Sushmita Vaidyanathan and Mradul Gupta and Saranya Paulraj and Abhi Sindhuja and Preethy Narayanasamy},
journal = {Plastic and reconstructive surgery. Global open},
year = {2026},
month = oct,
doi = {10.1097/gox.0000000000008186},
url = {https://europepmc.org/article/MED/42921372},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Redefining Gynecomastia Grading Using Anthropometric Parameters and Surgical Algorithm for Gynecomastia: A Single-center Study.
AU - Karthik Ramasamy
AU - Mohammed Nishar Samiulla
AU - Sushmita Vaidyanathan
AU - Mradul Gupta
AU - Saranya Paulraj
AU - Abhi Sindhuja
AU - Preethy Narayanasamy
PY - 2026
DA - 2026/10/23
JO - Plastic and reconstructive surgery. Global open
DO - 10.1097/gox.0000000000008186
UR - https://europepmc.org/article/MED/42921372
AB - Background Gynecomastia is a benign enlargement of male breast tissue. Traditional classifications, such as those by Simon and Rohrich, rely mainly on clinical judgment, leading to interobserver variability and surgical planning. A need exists for a measurable, reproducible objective grading method. This study proposes a gynecomastia classification system integrating anthropometric parameters such as nipple-to-pectoralis major distance and chest circumference difference. These objective measures aim to enhance grading reliability and surgical planning.Methods A total of 134 patients who underwent gynecomastia correction between January and December 2024 were analyzed. Statistical analysis was performed using R software version 4.2. Receiver operating characteristic analysis determined the area under the curve, optimal cutoff points, and sensitivity and specificity.Results In our modification, we assess severity using 2 objective measurements: the nipple-to-pectoralis major muscle distance and the difference in chest circumference between the nipple level and the inframammary fold. Grade 1 corresponds to a distance of less than 2 cm and a circumference difference of less than 3 inches; grade 2, 2-4 cm and 3-4 inches; grade 3, 4-6 cm and 4-6 inches; and grade 4, more than 6 cm and more than 6 inches. These parameters serve as indirect yet reliable indicators of skin redundancy and breast size.Conclusions This grading system improves diagnostic accuracy and reproducibility in gynecomastia evaluation. It offers an objective, standardized framework that enhances communication and predictability of outcomes.
SN - 2169-7574
ER -