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Dean Destructo
06-01-2016, 11:56 PM
GMS Interdiscip Plast Reconstr Surg DGPW. 2016 Feb 23;5:Doc10. doi: 10.3205/iprs000089. eCollection 2016.
Combined approach for gynecomastia.
El-Sabbagh AH1.
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Abstractin English, German
BACKGROUND:
Gynecomastia is a deformity of male chest. Treatment of gynecomastia varied from direct surgical excision to other techniques (mainly liposuction) to a combination of both. Skin excision is done according to the grade. In this study, experience of using liposuction adjuvant to surgical excision was described.


PATIENTS AND METHODS:
Between September 2012 and April 2015, a total of 14 patients were treated with liposuction and surgical excision through a periareolar incision. Preoperative evaluation was done in all cases to exclude any underlying cause of gynecomastia.


RESULTS:
All fourteen patients were treated bilaterally (28 breast tissues). Their ages ranged between 13 and 33 years. Two patients were classified as grade I, and four as grade IIa, IIb or III, respectively. The first 3 patients showed seroma. Partial superficial epidermolysis of areola occurred in 2 cases. Superficial infection of incision occurred in one case and was treated conservatively.


CONCLUSION:
All grades of gynecomastia were managed by the same approach. Skin excision was added to a patient that had severe skin excess with limited activity and bad skin complexion. No cases required another setting or asked for 2(nd) opinion.


KEYWORDS:
gynecomastia; liposuction; periareolar incision; surgical excision

Surgical Strategies in the Treatment of Gynecomastia Grade I-II: The Combination of Liposuction and Subcutaneous Mastectomy Provides Excellent Patient Outcome and Satisfaction.Schröder L (http://www.ncbi.nlm.nih.gov/pubmed/?term=Schr%C3%B6der%20L%5BAuthor%5D&cauthor=true&cauthor_uid=26557823)1, Rudlowski C (http://www.ncbi.nlm.nih.gov/pubmed/?term=Rudlowski%20C%5BAuthor%5D&cauthor=true&cauthor_uid=26557823)1, Walgenbach-Brünagel G (http://www.ncbi.nlm.nih.gov/pubmed/?term=Walgenbach-Br%C3%BCnagel%20G%5BAuthor%5D&cauthor=true&cauthor_uid=26557823)2, Leutner C (http://www.ncbi.nlm.nih.gov/pubmed/?term=Leutner%20C%5BAuthor%5D&cauthor=true&cauthor_uid=26557823)3, Kuhn W (http://www.ncbi.nlm.nih.gov/pubmed/?term=Kuhn%20W%5BAuthor%5D&cauthor=true&cauthor_uid=26557823)1, Walgenbach KJ (http://www.ncbi.nlm.nih.gov/pubmed/?term=Walgenbach%20KJ%5BAuthor%5D&cauthor=true&cauthor_uid=26557823)4.
Author information (http://www.ncbi.nlm.nih.gov/pubmed/26557823#)

AbstractBACKGROUND:<abstracttext label="BACKGROUND" nlmcategory="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.</abstracttext>
METHODS:<abstracttext label="METHODS" nlmcategory="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.</abstracttext>
RESULTS:<abstracttext label="RESULTS" nlmcategory="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%).</abstracttext>
CONCLUSIONS:<abstracttext label="CONCLUSIONS" nlmcategory="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 surgicaltreatment with a low rate of complications and excellent patient satisfaction. Preoperative workup is important to rule out specific diseases or malignancy causing the GM.</abstracttext>