Surgical Management of Gynecomastia: Subcutaneous Mastectomy and Liposuction
Tóm tắt
The treatment of gynecomastia depends on multiple factors, and the best modality is controversial. In this study, we aimed to determine the best management approach by comparing outcomes of two groups of patients with gynecomastia who received subcutaneous mastectomy combined with liposuction and liposuction only. We conducted a retrospective analysis of 64 patients who underwent surgery for gynecomastia. We divided the patients into two groups: group A, patients who underwent liposuction only; and group B, patients who underwent liposuction and subcutaneous mastectomy. The serial photographs of all patients were clinically evaluated with respect to size, shape, scarring, and overall outcome by three plastic surgeons, and patient satisfaction was surveyed with regard to palpable lumps, size, shape, scarring, and overall outcome. Of the 64 subjects, 16 received liposuction only, and 48 received the combination procedure. A total of 125 breasts were involved. The doctors’ scores for size and overall outcome were significantly better in the combination group, whereas scarring was better in the liposuction-only group. Similarly, patient satisfaction regarding size was significantly higher in the combination group, and satisfaction regarding scarring was significantly higher in the liposuction-only group. The scores for scarring in the combination treatment group were acceptable. Our study shows that combination treatment with liposuction and subcutaneous mastectomy results in satisfactory outcomes, including the extent of scarring. We conclude that this combination treatment should be recommended as the standard surgical treatment for gynecomastia and can provide excellent results in cases where glandular tissue needs to be removed. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors
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Tài liệu tham khảo
Nuttall FQ (1979) Gynecomastia as a physical finding in normal men. J Clin Endocrinol Metab 48:338–340
Niewoehner CB, Nuttal FQ (1984) Gynecomastiaina hospitalized male population. Am J Med 77:633–638
Rochefort H, Garcia M (1983) The estrogenic and antiestrogenic activities of androgens in female target tissues. Pharmacol Ther 23:193–216
Treves N (1958) Gynecomastia; the origins of mammary swelling in the male: an analysis of 406 patients with breast hypertrophy, 525 with testicular tumors, and 13 with adrenal neoplasms. Cancer 11:1083–1102
Bembo SA, Carlson HE (2004) Gynecomastia: its features, and when and how to treat it. Cleve Clin J Med 71:511–517
Rohrich RJ, Ha RY, Kenkel JM, Adams WP Jr (2003) Classification and management of gynecomastia: defining the role of ultrasound-assisted liposuction. Plast Reconstr Surg 111:909–923
Celebioğlu S, Ertaş NM, Ozdil K, Oktem F (2004) Gynecomastia treatment with subareolar glandular pedicle. Aesthetic Plast Surg 28:281–287
Tashkandi M, Al-Qattan MM, Hassanain JM, Hawary MB, Sultan M (2004) The surgical management of high-grade gynecomastia. Ann Plast Surg 53:17–21
American Society of Plastic Surgeons (2002) ASPS recommended insurance coverage criteria for third-party payers. http://www.plasticsurgery.org/Documents/medical-professionals/health-policy/insurance/Gynecomastia-Insurance-Coverage.pdf
Braunstein GD (2007) Clinical practice. Gynecomastia. N Engl J Med 357:1229–1237
Mentz HA, Ruiz-Razura A, Newall G, Patronella CK, Miniel LA (2007) Correction of gynecomastia through a single puncture incision. Aesthetic Plast Surg 31:244–249
Lee JH, Kim IK, Kim TG, Kim YH (2012) Surgical correction of gynecomastia with minimal scarring. Aesthetic Plast Surg 36(6):1302–1306
Prado AC, Castillo PF (2005) Minimal surgical access to treat gynecomastia with the use of a power-assisted arthroscopic-endoscopic cartilage shaver. Plast Reconstr Surg 115:939–942