Assessment of Skin Redraping After Liposuction In Treatment of Gynecomastia Grade III Simon`s Classification

Abstract

Background: Gynecomastia is the most common breast disorder in men. The usual treatment of grade III is surgical excision of the excess skin which may cause embarrassment and dissatisfying results. Objective: To evaluate skin redraping after traditional liposuction in management of grade III gynecomastia Simon`s classification. Patients and Methods: In this study, 20 patients with grade III gynecomastia were selected with age group between 18 and 40 years old with mean 28.25 ± 4.18, 18 patients were idiopathic while 2 patients were drug induced, 19 cases were bilateral and one case were unilateral. It was a prospective observational cohort study to assess the effectiveness traditional liposuction for correction of grade III gynecomastia with excision of the gland through a semicircular infraareolar incision when needed, 11 cases underwent surgical gland excision while 9 cases didn"t need to. The study was conducted at Al-Azhar university hospitals (Al-Hussien and Sayed Galal). Results: Age group ranged from 18 to 40 with a mean on 28.25 ±4.18. The subjective results for all patients at 3 months assessment point. Four patients scored very satisfied, eight stated satisfied, another four stated neither satisfied nor dissatisfied while three patients declared dissatisfaction and only one was very dissatisfied. The average sternal notch to nipple length pre and three months postoperative were respectively 27cm and 22cm. Many factors have contributed in our success rate; the selection of young nonsmoker patient with no co morbid diseases or evidence of defective elasticity (varicosities or hernias), the adequate preparation, amount and duration of the tumescent and the proper choice of the corset size and fiber as well as wearing it for the whole time of the study (3 months). The semicircular periareolar incision scars are not well defined as it become camouflaged by the color change between normal skin areola. Conclusion:Conventional liposuction alone could be a reliable method to treat grade III gynecomastia in young patient with a good skin quality and helps in avoidance of undesirable scars.