liposuction assisted de-epithelialization pull-through technique for management of grade IIB and III gynecomastia

Elhadidy, Rowan Almoddather; ibrahim, Ahmed abdelmonem; Shoman, Omar Osama; El sherifa, Ahmed Abdel Fattah

doi:10.21608/ejprs.2023.249082.1318

	liposuction assisted de-epithelialization pull-through technique for management of grade IIB and III gynecomastia
The Egyptian Journal of Plastic and Reconstructive Surgery
Articles in Press, Accepted Manuscript, Available Online from 27 November 2023
Document Type: Original Article
DOI: 10.21608/ejprs.2023.249082.1318
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Authors
Rowan Almoddather Elhadidy ¹; Ahmed abdelmonem ibrahim²; Omar Osama Shoman³; Ahmed Abdel Fattah El sherifa³
¹Plastic, Burn, and Reconstructive surgery department, Faculty of medicine, Mansoura University Hospitals
²general surgery department, faculty of medicine, Mansoura University
³Plastic, Burn, and Reconstructive surgery department, Faculty of medicine, Mansoura university.
Abstract
Background: Gynecomastia is an abnormal and benign enlargement of male breast tissue. It occurs as a result of an imbalance between estrogen and androgen levels that may be due to a physiological or pathological cause. Multiple surgical approaches have been recommended to manage this problem. It is widely accepted that liposuction solely or when combined with subcutaneous mastectomy is effective for the management of low to intermediate grades of gynecomastia. However, liposuction along with subcutaneous mastectomy gives unsatisfactory results in high grades where there is excess redundant skin that needs excision. Several skin incisions have been mentioned in literature for excision of excess skin, however, some of these are accompanied by unaesthetic scars. OBJECTIVE: To assess the outcome of surgical correction of high grades of gynecomastia in a single-stage procedure. METHOD: We conducted a prospective analysis on 20 patients with grades IIb or III gynecomastia who underwent single-stage procedures. Photographs were clinically evaluated by two independent surgeons with respect to chest contour, symmetry, scar, and residual ptosis. Patient satisfaction was surveyed regarding chest contour and scar appearance. RESULTS: Statistical analysis revealed a significant improvement in patient’s clinical measurements after operation, good doctor’s scoring and patient satisfaction scoring among studied cases, and accepted complication rates. CONCLUSION: The current approach eliminates the need for skin resection in a second surgery, permits immediate skin recontouring, and achieves an acceptable aesthetic scar.
Keywords
Gynecomastia; circum-areolar incision; gland excision; grades IIB and III; scar


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