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Surgeon in a bright operating room environment.

Understanding Chest Fold Sag in Gynecomastia Cases

Chest Fold Sag

  • Chest fold angle is the single most important measurement in determining gynecomastia type and optimal treatment.
Gyne Type Chest fold angle
Type 1 < 45
Type 2 < 60
Type 3 60-90
Type 4 > 90

Pencil test – place a pencil 2 cm above your chest fold to simulate reconstruction of the chest fold support system and correction of rounded chest. This 2 cm area of skin needs to be flat because leaving a persistent skin fold fails to recreate a masculine chest. In addition, it looks like there is persistent breast tissue.