All of the following statements about Gynecomastia are TRUE, EXCEPT:
Correction of the primary cause is the initial treatment of choice in gynecomastia. Indications for surgical treatment of gynecomastia includes: gynecomastia persisting for long duration, psychologic or cosmetic problems, continued growth, tenderness or suspicion of malignancy. Surgical treatment of choice in such cases includes simple liposuction with minimal glandular resection through a periareolar incision as necessary. Subcutaneous mastectomy is not the initial surgical approach. Ref: Harrison's Principles of Internal Medicine, 16th Edition. Page 2192; R Alagappan, Manual Of Practical Medicine, 3rd Edition, Page 602
It can be drug induced
It is seen in liver disease
Associated with an estrogen / testosterone imbalance
Subcutaneous mastectomy is the initial treatment of choice