From Etiology to Aesthetic Surgery: Mapping Knowledge Domains and Emerging Trends in Gynecomastia Research: 35-Year Bibliometric Analysis

Background Gynecomastia is a benign proliferation of glandular tissue in the male breast, with incidence rate of 30–60% among adolescents. Its etiology involves physiological hormonal fluctuations, pathological conditions, and pharmacologic factors. It causes psychological burdens like body dysmorphic disorder and anxiety. Traditional reviews can’t synthesize numerous fragmented evidence, making objective and quantitative analysis needed. Method The Web of Science Core Collection (SCIE) was data source to search literature about "gynecomastia" from 1990 to December 2024. After PRISMA process and triple-blind screening by three plastic surgery doctors, 863 English original articles were included. Software like CiteSpace, VOSviewer, and Excel were used for bibliometric and visual analysis. Result Research showed three-stage stepwise growth trend. The United States was core of research (203 publications, betweenness centrality of 0.37). High-productivity institutions were mostly comprehensive universities and specialized hospitals. Author collaboration was decentralized. Core journals focused on plastic surgery and endocrinology fields. 12 keyword clusters were identified. Clusters with latest average years were #0 chest remodeling, #8 androgen receptor, and #9 dietary supplements. The ongoing hot issues include "risk factors,” "minimally invasive surgery,” "endoscopic treatment,” "hair removal,” "crystallized phenol,” "quality of life,” "explanation minimally invasive treatment,” and "efficacy.” Conclusion This study visually presents research landscape and developmental trends in the gynecomastia field since 1990. Future research should focus on cases about elderly population, establish multidisciplinary teams (MDT), strengthen real-world studies, resolve conflicts between individual experiences, esthetics, and traditional social gender norms, and explore new technologies’ application like 3D printing and AI-assisted analysis. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors. www.springer.com/00266 .