Surgical Strategies in the Treatment of Gynecomastia Grade I-II: The Combination of Liposuction and Subcutaneous Mastectomy Provides Excellent Patient Outcome and Satisfaction

Abstract

Background: Gynecomastia (GM) is a benign condition with glandular tissue enlargement of the male breast. GM is classified into 4 grades of increasing severity. We describe a series of GM grade I-II, diagnosed, treated surgically and analyzed regarding feasibility, complication rate, and satisfaction. Methods: From 2005 to 2012, a chart review was performed for 53 patients. Preoperative examination included endocrine and urological examination and exclusion of other pathological conditions. The surgical technique consisted of liposuction through an inframammarian-fold incision and excision of the glandular tissue by a minimal periareolar approach. Results: A total number of 53 male patients with 104 breasts were available for analysis. By liposuction, a median of 300 ml (range: 10-1000 ml) was aspirated from each breast and 25.1 g (range: 3-233 g) gland tissue was resected. Surgery lasted between 25 and 164 min per patient (median: 72 min). 2 postoperative hemorrhages occurred (n = 2, 3.8%). 2 patients underwent re-operation due to cosmetic reasons (n = 2, 3.8%). Conclusions: This analysis demonstrates that treatment of GM grade I-II can easily be performed by liposuction combined with subcutaneous resection of the glandular tissue as a minimally invasive and low-impact surgical treatment with a low rate of complications and excellent patient satisfaction. Preoperative workup is important to rule out specific diseases or malignancy causing the GM.

Evaluation of Glandular Liposculpture as a Single Treatment for Grades I and II Gynaecomastia

“…We had a median total operating time of 67 min and 700 ml of aspirated fat using the combined technique, which is in line with previous studies [19, 21]. We also had a shorter post-operative duration of hospital stay than previous studies [19, 21] which may be the result of the relative simplicity of liposuction that resulted in less post-operative pain and discomfort.…”

“…We also had a shorter post-operative duration of hospital stay than previous studies [19, 21] which may be the result of the relative simplicity of liposuction that resulted in less post-operative pain and discomfort.…”

“…Previous publications that have assessed patient satisfaction after treatment of gynaecomastia used different scales that assessed five or six items, most of which were related to the physical appearance of the breast [12, 18], or by measuring the overall satisfaction by means of yes/no answers [19–21]. The BEQ is more versatile and has been validated in general breast surgery [16] and gynaecomastia [9].…”

High Volume Adrenalin Solution Infiltration for Surgical Treatment of Gynaecomastia

“…Gynecomastia is described as the enlargement of male breast tissue [1]. It is a common condition that can be determined at various levels in 40-55% of males [2,3]. In addition to being able to occur due to the benign proliferation of the breast glandular tissue, gynecomastia can occur due to the increased adipose tissue amount on the pectoral muscle, and this latter condition is called pseudogynecomastia.…”

“…In most patients, these two conditions coexist [1]. Gynecomastia can occur due to hormonal imbalances during puberty, medications, malignancies, and chronic diseases but it is mostly idiopathic [1,2,4].…”