Inferior Pedicle Reduction Technique With Nipple Repositioning for Huge Gynecomastia

Abstract

Background : Gynecomastia (GM) is a common benign problem affecting males. Many surgical techniques have been described. We discuss in this study a technique used for large redundant male breast using deepithelialized inferior pedicle with nipple areola repositioning. Patients and method: The study included 10 patients (with total 20 breasts) with huge gynecomastia treated surgically using inferior pedicle technique. They were operated in Al Azhar university hospital between May 2015 and April 2017. All the patients have bilateral GM with age range from 30 to 48. The operation started by deepithelialization of the ellipse and dissection between the inferior glandular pedicle and chest wall removing breast tissue as we need. The superior breast flap was raised with thickness not more than 1-2 cm. A disc of skin and subcutaneous fat then removed at the future nipple-areola site at upper flap. The inferior pedicle pulled up under the upper flap and the nipple areola complex of the lower flap was then repositioned at the new site and sutures using prolene 5/0. Suction drain was used in all patients. Results: The operated 20 breasts ended by good asthetic results and patient satisfaction with only 3 breasts showed wound infection and 2 breasts showed seroma. Conclusion: The inferior pedicle method for the management of Simon grade  gynaecomastia is a satisfactory method for treatment of these severe cases.