An Ameliorated Approach for Sharp Resection in Gynecomastia Surgery

Abstract

Surgery has become the accepted standard for the majority of patients with gynecomastia to get rid of feminine-looking breast enlargement. Many surgical techniques have been proposed according to grade of gynecomastia. The sharp resection of glandular tissues is a keystone for most of them. However, technical difficulties in application and inexperience in mastectomy often lead to poor cosmetic outcomes. Over excision and saucer-like deformity, under resection, and asymmetries are most common ones among them. The author presents an ameliorated subcutaneous mastectomy method to facilitate the learning curve and to improve the esthetic results avoiding saucer-like deformity and other breast contour deformities. This method consists of an en bloc tissue dissection via superior periareolar incision and excision of fatty glandular tissue in suprafascial plan, with slicing and trimming procedure. It is possible to adjust the degree of tissue reduction during surgery; hence, it may be labeled as a "cut-as-you-go" technique. Between 2008 and 2012, 23 male patients were operated with this technique. Medical photographs and drawings were used to describe the technique. The operation resulted in smooth, symmetric breasts befitting to men in all 23 patients. No major complications were observed in any of the cases. None of the patients reported a discomfort in sensation of nipple-areolar complex. The presented technique provides high degree of patient satisfaction and excellent esthetic outcomes and is a promising choice in gynecomastia surgery with extremely low recurrence rates and easy learning curve.

Evaluation of the Aesthetic Outcome of Glandular Liposculpture Using V - Dissector Liposuction Cannula for Grades I and II Gynecomastia Combined with the Sealing Effect of Autologous Platelet Gel

“…It is the most frequent male breast problem, accounting for roughly 60% of the total male breast abnormalities [1]. Several traditional treatments, including liposuction, subcutaneous mastectomy, and a combination of both, have been documented [2]. Recently, there has been a tendency towards using a less invasive approach to stay away any open excision after the procedure of liposuction [3].…”

Liposuction and port site nipple sparing mastectomy: an alternative method for the operative treatment of gynecomastia at Alexandria main university hospital

“…Suction lipectomy or glandular breast tissue removal through a periareolar incision are two current standard surgical techniques [ 2 , 6 ]. Several clinical studies were conducted to compare the superiority of each technique in terms of esthetic results and complications [ 6 – 9 ].…”

Liposuction Assisted Gynecomastia Surgery With Minimal Periareolar Incision: a Systematic Review

“…Gynecomastia causes social anxiety and sometimes pain or tenderness [5]. When gynecomastia does not resolve spontaneously, it can be treated with either medical therapy or in adjunct with surgery [7]. Surgery is only indicated as last resort for patients with persistent gynecomastia and suspected malignancy.…”