Minimal invasive surgery for gynecomastia – A novel approach

Iwuagwu, Obi; Drew, PJ

doi:10.4172/plastic-surgery.1000402

Cited by 8 publications

(10 citation statements)

References 5 publications

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“…In comparison, introduction of the vacuum‐assisted mammotome biopsy device in the diagnosis and treatment of benign and early breast cancerous lesions has the advantages of minimal invasiveness, is carried out under local anesthesia and produces cosmetic results, with an incision as small as 4 mm being required and no implantation of drainage tubes. Iwagwu et al succeeded in treating gynecomastia and fibroadenoma using the mammotome technique and achieved considerable cost savings, excellent cosmesis and high patient satisfaction . Similar to the previous studies of Iwuagwu, treatment of gynecomastia with MAMIR demonstrated a significantly smaller postoperative scar size, shorter hospitalization and healing times, lower postoperative pain levels, and higher patient satisfaction.…”

Section: Discussionmentioning

confidence: 64%

“…Compared with traditional open surgery to treat breast lesions, mammotome‐assisted minimally invasive resection (MAMIR) has advantages in several respects such as a shorter hospital stay, operation time, smaller postoperative scar, and better healing conditions . Although the application of mammotome in resecting male mammary hypertrophy has been reported, there have been few studies which compared the curative effect between novel MAMIR and traditional open surgery for gynecomastia.…”

Section: Introductionmentioning

confidence: 99%

“…13 In addition as a diagnostic tool, mammotome has also been widely applied to assist therapeutic excision of benign breast lesions. 14 [15][16][17][18][19] Although the application of mammotome in resecting male mammary hypertrophy has been reported, 20 there have been few studies which compared the curative effect between novel MAMIR and traditional open surgery for gynecomastia.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of curative effects between mammotome‐assisted minimally invasive resection (MAMIR) and traditional open surgery for gynecomastia in Chinese patients: A prospective clinical study

Wang

et al. 2019

Breast J

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To analyze and compare prospectively the curative effects between mammotome‐assisted minimally invasive resection (MAMIR) and traditional open surgery (TOS) for gynecomastia in Chinese male patients, a total of 60 patients suffering from grade I and II gynecomastia, evaluated by automated whole‐breast ultrasound (AWBU), were recruited and randomly divided into TOS and MAMIR groups (each n = 30). The postoperative scar size, healing time, patient hospital stay, postoperative satisfaction, postoperative pain, and complications including edema and bruising were analyzed. The participants were followed up for 1 week, 1 month, 6 months, and 1 year after surgery. Compared with patients who received TOS, patients in the MAMIR group had significantly smaller scar sizes (0.40 ± 0.08 cm vs 5.34 ± 0.38 cm, P < 0.01), shorter healing times (3.67 ± 0.71 days vs 7.90 ± 0.92 days, P < 0.01), and hospitalization (2.60 ± 0.62 vs 7.17 ± 0.83 days, P < 0.01), as well as higher postoperative satisfaction (4.70 ± 0.60 vs 3.20 ± 0.55 scores, P < 0.01), respectively. Patients in the MAMIR group experienced postoperative mild pain significantly more often than those in the TOS group (6.70 ± 1.06 vs 4.13 ± 0.78 scores, P < 0.01, respectively), but with significantly less postoperative severe pain (53.33% vs 0.00%, P < 0.000). While the incidence rate of edema and bruises was significantly higher in the MAMIR group compared with the TOS group (47% vs 17%, P = 0.013 and 54% vs 20%, P = 0.007, respectively). MAMIR had advantages for curative effects compared with traditional open surgery. However, the recurrence rate in patients needs to be further studied.

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Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of curative effects between mammotome‐assisted minimally invasive resection (MAMIR) and traditional open surgery for gynecomastia in Chinese patients: A prospective clinical study

Wang

et al. 2019

Breast J

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“…Three main surgically relevant classification systems have been described to categorize gynecomastia: Webster's, Simon's, and Rohrich's. Based on tissue type (presence of glandular vs fatty tissue; Table 1), Webster's classification describes three main categories 8,[9][10][11] : Type I identifies mainly glandular tissue present; Type II includes a mix of fatty and glandular tissue; and Type III has mainly simple fatty tissue present. 4 This classification is of importance when considering surgical modality, as will be discussed.…”

Section: Introductionmentioning

confidence: 99%

“…[12][13][14] The second classification, Simon's, delineates grades of gynecomastia with additional subcategories, including amount of tissue and excess skin (Table 2). 4,8,11,15,5 Grade I reflects no skin redundancy/excess and minor breast enlargement. Grade IIa indicates no skin redundancy/excess and with moderate breast enlargement; however, if skin excess/redundancy is present, then it is Grade IIb.…”

Section: Introductionmentioning

confidence: 99%

Case Report: The TRTMI Procedure, a Novel Surgical Technique for Gynecomastia

Nashed¹,

Branman²

2020

Am J Cosmet Surg

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Gynecomastia presents the most common breast issue in men. It is defined as benign proliferation and enlargement of male breast glandular tissue that distributes most prevalently among neonates, adolescents, and elderly men. With a prevalence of over 60% in the male population, various classifications and treatment options have emerged to address male gynecomastia. Surgical treatment presents challenges and is used when gynecomastia has been present for several years or if medical therapy has been unsuccessful. We attempt to address some of these surgical challenges as they relate to aesthetic goals by presenting our surgical technique. Our surgical technique, the Tissue Resection Through Minimal Incision method, is described with illustrations included. Surgical candidates are selected after a review of the patient’s history, a thorough physical evaluation, obtaining any necessary imaging, and a detailed discussion with the patient. A hybrid, minimally invasive, and direct excision technique is used, including both standard VASER liposuction and direct glandular tissue resection via only a single 3-mm, well-hidden incision using simple instruments readily available with reproducible outcomes. We stress the idea of tissue inversion being key to make this feasible. Several case examples are presented with before and after comparisons, demonstrating good aesthetic results and skin retraction. In the more than 80 cases performed, one patient presented with dusky nipple areolar complex in the recovery room, which resolved with topical nitroglycerin. No nipple areolar complex necrosis occurred, nor hospitalizations were required for the cases performed. A few cases of tissue edema and swelling occurred correlating with inadequate compression or strenuous activity. Incisions were well hidden and aesthetically pleasing to patients. We briefly review gynecomastia classification and treatment options focused on surgical approaches. Of the various surgical methods available to treat gynecomastia, limitations and challenges include unfavorable scar and risk profiles, as well as inadequacy of tissue resection with the minimally invasive techniques. To meet this unmet need, our patented Tissue Resection Through Minimal Incision technique offers a novel minimally invasive approach that includes adequate tissue excision while maximizing aesthetic results and with nominal scarring. There is great need in surgical treatment of gynecomastia to minimize incisions and improve outcomes. Glandular tissue excision is a challenge to the cosmetic profile because of incisions used. Our novel technique and benefits involved address those concerns. However, our procedure does not address gynecomastia cases with excessive skin redundancy that requires excision. Further studies are still needed to address such challenges regarding aesthetic profile goals.

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