Keywords
Areola incision
Liposuction
Surgery
Submitted : 2023-05-11
Accepted : 2023-05-26
Published : 2023-06-10
Abstract
Objective: To investigate the clinical effect of liposuction combined with subareolar incision glandectomy in the treatment of Simon Grade Ⅲ adipo-glandular gynecomastia (GYN). Methods: From March 2021 to March 2022, the data of patients with Simon Grade Ⅲ adipo-glandular GYN treated by liposuction combined with glandectomy in the Department of Plastic Surgery, Zhongshan Hospital Affiliated to Dalian University and Henan Plastic Surgery and Aesthetic Hospital were retrospectively analyzed. Based on the medical records, color ultrasound was performed on the patient’s breast before surgery, which was determined to be GYN (more than 50% glandular tissue). A 3 mm long incision was made at the lower boundary of the surgical range, through which the adipose tissue in the hypertrophic region of the breast was repeatedly aspirated until a satisfactory thickness was achieved. The residual glandular tissue was removed by a semicircular arc incision under the areola, and then the areola incision was sutured in position. The blood flow, sensation, and wound healing of bilateral nipples and areola were observed after surgery, and the morphology of bilateral thorax and scar of incision were followed up. Results: A total of 15 GYN patients aged 18 to 35 years with body mass index of 23.8 to 26.5 kg/m2 (mean = 24.8 kg/m2) were included in this study. The average intraoperative liposuction volume of unilateral breast was 170 mL (150–200 mL), the average glandectomy volume was 115 g (95–125 g), and the average blood loss was about 40 mL (15–75 mL). Postoperative hypertrophic breast volume decreased significantly, and no complications such as hematoma, infection, skin ischemic necrosis, or sensory disturbance occurred in the nipple and areola, during the healing process. The patients were followed up for 3 to 6 months, and the bilateral thorax was smooth, symmetrical, and natural in contour. The incision was concealed, and the scar was not obvious. Conclusion: Liposuction combined with subareolar incision glandectomy in the treatment of Simon Grade Ⅲ adipo-glandular GYN is safe. The postoperative chest contour is smooth and natural, and the scar is small and invisible, which achieves good aesthetics.
References
He K, Liu S, Yu Z, 2016, Male Breast Cancer and Gynecomastia Identification and Related Research Progress. Chinese Journal of Medical Oncology Surgery, 8(3): 163–166.
Longheu A, Medas F, Corrias F, et al., 2016, Surgical Management of Gynecomastia: Experience of A General Surgery Center. Chir, 37(4): 150–154.
Simon BE, Hoffman S, Kahn S, 1973, Classification and Surgical Correction of Gynecomastia. Plast Reconstr Surg, 51(1): 48–52.
Sir E, Üçer O, Aksoy A, et al., 2016, Sexual Function and Hormone Profile in Young Adult Men with Idiopathic Gynecomastia: Comparison with Healthy Controls. Breast Dis, 36(1): 1–4.
Braunstein GD, 2007, Clinical Practice: Gynecomastia. N Engl J Med, 357(12): 1229–1237.
Brown RH, Chang DK, Siy R, et al. 2015, Trends in the Surgical Correction of Gynecomastia. Semin Plast Surg, 29(2): 122–130.
Lu H, Lou L, Wang H, et al., 2020, Study on the Value of Breast-Assisted Liposuction Adenectomy in the Treatment of Gynecomastia. Chinese Modern Doctor, 58(1): 52–55.
Sansone A, Romanelli F, Sansone M, et al., 2017, Gynecomastia and Hormones. Endocrine, 55(1): 37–44.
Soliman AT, De Sanctis V, Yassin M., 2017, Management of Adolescent Gynecomastia: An Update. Acta Biomed, 88(2): 204213.
Zhu H, 2021, Clinical Analysis of Endoscopic Treatment of Severe Gynecomastia. China Practical Medicine, 16(17): 74–76.
Ordaz DL, Thompson JK, 2015, Gynecomastia and Psychological Functioning: A Review of the Literature. Body Image, 15: 141–148.
Cai J, Yang J, 2005, Current Status of Etiopathology of Gynecomastia. Chinese Journal of Practical Cosmetic and Plastic Surgery, 16(3): 169–171.
Webster JP, 1946, Mastectomy for Gynecomastia Through a Semicircular Intra-Areolar Incision. Ann Surg, 124(3): 557–575.
Wang W, Plastic Surgery Department. Hangzhou: Zhejiang Science and Technology Press, 1999:1170–1172.
Wani SA, Rabah SM, AlFadil S, et al., 2015, A Novel Method of Marking Nipple Areola Complex in Gynaecomastia Surgery. Indian J Plast Surg, 48 (1): 96.
Nuzzi LC, Cerrato FE, Erikson CR, et al., 2013, Psychosocial Impact of Adolescent Gynecomastia: A Prospective Case-Control Study. Plast Reconstr Surg, 131(4): 890–896.