Single axillary incision endoscopic surgery and liposuction for gynecomastia

Abstract

Gynecomastia is a common type of breast tissue hypertrophy in men. Surgical excision is the most effective treatment for this condition. Minimally invasive surgical techniques can be used to avoid visible chest scarring. In this study, we evaluated the efficacy and safety of single-axillary-incision endoscopic mastectomy and liposuction for the treatment of gynecomastia. Nipplesparing mastectomy via a single-port axillary incision was successfully performed in all patients. Twenty-four bilateral procedures were performed in total. Twenty patients underwent liposuction concomitantly. The median weight of the mastectomy pieces was 88.5 g (range: 42.5-440 g), and the median amount of liposuction was 262.5 cc (range: 25-350 cc). The median duration of surgery was 120 minutes (range, 73-195 minutes). Two patients developed a seroma, and 1 patient developed a hematoma in the early postoperative period. The mean satisfaction levels related to physical appearance, mental status, and social environment were 8.75 (standard deviation [SD]: 1.19), 9.17 (SD: 1.44), and 9.33 (SD: 0.76) points, respectively, on a 10-point visual analog scale. Endoscopic single-port nipple-sparing mastectomy combined with liposuction is a technically feasible method to avoid anterior chest wall scarring with good cosmetic results. Between June 2021 and June 2022, 30 patients underwent endoscopic singleport nipple-sparing mastectomy through a small axillary incision, while 20 underwent concomitant liposuction. The demographic information of the patients, duration of surgery, amount of tissue removed, and complications were recorded. Patients' levels of satisfaction with their physical appearance, mental status, and social environment were measured.Abbreviations: BMI = body mass index, EM = endoscopic mastectomy, SD = standard deviation, VAS = visual analog scale.

A Novel Surgical Technique for Gynecomastia: Air-Assisted Minimally Invasive Surgery With Single Axillary Incision

“…Varlet et al performed endoscopic subcutaneous mastectomy with 3 ports and in their study, the mean operation time was found to be 93 minutes for each breast. 13 Tukenmez et al 19 performed endoscopic mastectomy from a single axillary incision for 30 gynecomastia patients and they reported 120 minutes of median operation time. The technique we described does not use a port or continuous insufflation, and as a consequence problems and difficulties of endoscopic surgery wouldn't occur.…”