Are surgical guidelines realistic?

doi:10.1136/bmj.39542.719699.BE

BMJ 2008;336:790 (12 April), doi:10.1136/bmj.39542.719699.BE

Letters

Gynaecomastia

Are surgical guidelines realistic?

The first 100% of the full text of this article appears below.

Surgery is considered to be a low priority aesthetic procedurein benign gynaecomastia¹ and in the UK has risen by 27% in 2007in comparison to 2006.² In some regions affected men would notbe offered surgical treatment on the NHS.³ Our 2006 regionalguidelines suggest that 200 g of tissue should be excised fromeach side to warrant surgery on the NHS. Our audit of 48 menwho underwent surgery for benign gynaecomastia on the NHS between2003 and 2006 found that only three would have met the guidelinecriteria for surgery on the NHS. We wonder whether the governmentguidelines are realistic.

Negin Shamsian, specialist registrar plastic surgery, Oxford rotation, Luke Jones, ST2 surgery, Oxford rotation, Sudip Ghosh, consultant plastic surgeon

¹ Stoke Mandeville Hospital, Aylesbury, Buckinghamshire HP21 8AL

neginshamsian@yahoo.com

Competing interests: NS and LJ completed a gynaecomastia auditentitled "A retrospective review of gynaecomastia surgery andweights of tissue excision in 2007." Roger Ramcharan and PeterBudny were contributors on the audit.

Niewoehner CB, Schorer AE. Gynaecomastia and breast cancer in men. BMJ 2008;336:709-13. (29 March.)[Free Full Text]
BAAPS Statistics 2007. www.baaps.org.uk/content/view/280/62/
Oxfordshire NHS Trust Priorities Forum policy statement. www.oxfordshire.nhs.uk/docs/lavender/policy6b2.pdf