Gynecomastia: The Horizontal Ellipse Method for Its Correction

Gheita, A

doi:10.1007/s00266-008-9190-2

Cited by 18 publications

(12 citation statements)

References 6 publications

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“…The technique with inferior pedicle can be performed in almost all cases, accept for patients with large distances between the NAC and the inferior incision, since the extended pedicle length may result in flap necrosis. In such cases, when the distance between the NAC and the upper incision is smaller than the distance between the NAC and the inferior incision, a superior pedicle for NAC transfer may be performed, nevertheless precluding the ability of NAC positioning superior to the resulting scar [4].…”

Section: Discussionmentioning

confidence: 97%

“…Treatment of gynecomastia is dependent on the extent of mammary hypertrophy and the amount of skin excess, resulting in multiple methods such as combined liposuction with subcutaneous mastectomy, with or without excessive skin removal, in severe cases with free nipple-areola grafting. In cases of gynecomastia with minimal mammary hypertrophy and most cases of pseudogynecomastia, treatment options include free nipple-areola grafting versus superiorly or inferiorly based pedicle techniques for nipple-areola preservation [4,5]. The more time-consuming pedicled transposition of the nipple-areola complex (NAC) allows for preservation of the neurovascular system with a more natural appearance without the risk of depigmentation [5].…”

Section: Introductionmentioning

confidence: 99%

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Central Pedicled Breast Reduction Technique in Male Patients After Massive Weight Loss

2011

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Male patients after massive weight loss often suffer from redundant skin and soft tissue in the anterior and lateral chest region, causing various deformities of pseudogynecomastia. Techniques with free or pedicled nipple-areola complex (NAC) transposition are widely accepted. The authors present their approach to male breast reduction with preservation of the NAC on a central dermoglandular pedicle and a wide elliptical tissue excision of breast and lateral thorax tissue in combination with liposuction. Male breast reduction was performed on patients after moderate to massive weight loss due to diet or bariatric procedures. Former procedures included free nipple-areola grafts or inferior pedicled techniques for NAC preservation. As a modification, we performed a central pedicled breast reduction on nine male patients with excessive liposuction of the pedicle and a horizontal elliptical skin removal, allowing for sufficient tissue removal at the lateral thorax. From October 2010 until June 2011, nine male patients had central pedicled breast reconstructions after massive weight loss. Mean age was 29.1 years, mean preoperative body mass index was 29.2, and mean preoperative weight loss was 63.9 kg. The chest wall improvement was rated "very good" by eight patients. No major complications occurred in all nine patients. Male chest deformities after massive weight loss can be dealt by several approaches. The optimal scar positioning and the preservation of NAC may be the most challenging aspects of these procedures. Therefore, the preservation of the NAC on a central dermoglandular pedicle with a horizontal submammary scar course may optimize the esthetic outcome.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Central Pedicled Breast Reduction Technique in Male Patients After Massive Weight Loss

2011

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“…In latter times, preservation of nipple-areolar complex on a de-epithelised flap[7] , inferior pedicle reduction technique[8] , horizontal ellipse with superior pedicel flap[9] , bipedicle flap[10] etc were described to keep the neuro-vascular supply of the NAC complex intact, but these surgical techniques usually produce scars over male chest, which is aesthetically unappealing.…”

Section: Discussionmentioning

confidence: 99%

Role of combined circumareolar skin excision and liposuction in management of high grade gynaecomastia

Sarkar

Bain

Bhattacharya

et al. 2014

J Cutan Aesthet Surg

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Introduction:High-grade gynaecomastia (Simon IIb and III) has tissue excess (skin excess, enlarged areola, and displaced nipple), which is best managed surgically; however, results of conventional breast reduction surgeries and liposuction is not very good. Aim of our study was to describe a combined technique to manage these problems to produce a good result.Material and Method:This was a 2-year study among 12 patients of high grade gynaecomastia. Clinical and laboratory findings were normal. Pre-operatively in standing position, diameter of breast and areola, position of nipple, and amount of skin excess were marked. Under general anaesthesia, tumescent infiltration, circumareolar de-epithelisation of skin excess, and liposuction was completed. Redundant portion of the breast was sharply dissected and pulled out. Areola was fixed over pectoralis fascia at mid humerus level, just medial to the mid-clavicular line. Outer borders of the de-epithelised area were apposed by the purse-string effect of a subdermal suture, and further apposed by few half buried horizontal mattress sutures. Drains for 24 hour and compressive dressings for 6 weeks were used.Result:Mean age of presentation was 25.8 year; emotional discomfort was the chief complaint. Among 12 patients, 10 patients had bilateral gynaecomastia and 8 patients had enlarged and displaced nipple-areola complex. Average hospital stay was 2.41 days and recoveries were usually uneventful.Conclusion:The problem of tissue excess and tissue displacement in high grade gynaecomastia can be well managed by this combined circumareolar skin reduction and liposuction technique to achieve a scar-less flat male chest.

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“…Ginecomastia causa grande impacto emocional e social nos homens, principalmente durante o período da puberdade 7 . As alterações na forma e no tamanho da mama levam os pacientes a interromper atividades cotidianas e de lazer, acarretando redução na qualidade de vida.…”

Section: Discussionunclassified

Tratamento cirúrgico da ginecomastia: uma análise criteriosa

Dornelas¹,

Machado²,

Gonçalves³

et al. 2010

Rev. Bras. Cir. Plást. (Impr.)

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Tratamento cirúrgico da ginecomastia: uma análise criteriosaSurgical treatment of gynecomastia: a critical analysis RESUMO Introdução: A ginecomastia é o aumento no tamanho da glândula mamária masculina, que pode ser fisiológico ou patológico, sendo condição passível de correção. Objetivo: Analisar o tratamento cirúrgico da ginecomastia, apontando suas principais complicações. Método: Duzentos e oitenta e quatro pacientes foram submetidos a cirurgia para correção da ginecomastia entre janeiro de 1998 e setembro de 2008, sendo 94,37% dos pacientes graus I e II e 5,63%, grau III. Resultados: Em relação ao total de pacientes, 3,87% apresentaram seroma e 2,11%, hematoma (p<0,001). A aná-lise dos pacientes graus I e II revela que 0,74% apresentaram cicatrizes hipertróficas nas incisões de lipoaspiração (p<0,001). Dentre os pacientes submetidos à técnica de Davidson, 18,75% apresentaram alargamento do complexo aréolo-mamilar (p=0,108) e foram submetidos a cirurgia para correção. Conclusão: As técnicas utilizadas para correção de ginecomastia se mostraram eficazes e seguras.Descritores: Ginecomastia/cirurgia. Mama/cirurgia. Masculino. SUMMARY Introduction:The gynecomastia is an increase in male breast and an important impact on quality of life. However, it is a condition likely to be modified. Objective: To analyze the surgical treatment of gynecomastia pointing the major complications. Methods: Two hundred and eighty-four patients underwent surgery to correct gynecomastia from January 1998 to September 2008, 94.37% of patients were grade I and II and 5.63%, grade III. Results: 3.87% patients had seromas and 2.11%, hematoma (p<0.001). Patients grade I and II had keloids in incision of liposuction (0.74%) and patients grade III presented areolar enlargement. Conclusion: The techniques used for treatment of gynecomastia were considered safe and effective with low complication rate.Descriptors: Gynecomastia/surgery. Breast/surgery. Male.

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Gynecomastia: The Horizontal Ellipse Method for Its Correction

Cited by 18 publications

References 6 publications

Central Pedicled Breast Reduction Technique in Male Patients After Massive Weight Loss

Central Pedicled Breast Reduction Technique in Male Patients After Massive Weight Loss

Role of combined circumareolar skin excision and liposuction in management of high grade gynaecomastia

Tratamento cirúrgico da ginecomastia: uma análise criteriosa

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