The Modified Surgical Treatment of Gynecomastia: Pan-cake Method

여성형 유방증(Gynecomastia)의 개선된 수술적 치료방법: 팬 케이크 법(Pan-cake Method)

  • Park, Jin Hong (Department of Plastic and Reconstructive Surgery, College of Medicine, Seoul National University) ;
  • Lee, Yoon Ho (Department of Plastic and Reconstructive Surgery, College of Medicine, Seoul National University)
  • 박진홍 (서울대학교 의과대학 성형외과학교실) ;
  • 이윤호 (서울대학교 의과대학 성형외과학교실)
  • Received : 2007.03.19
  • Published : 2007.09.10

Abstract

Purpose: Subcutaneous mastectomy has been accepted as a standard for the treatment of gynecomastia. Surgical managements including ultrasound-assisted liposuction(UAL) have had limited success and several combined approaches were tried to find the most effective method. We designed a modified subcutaneous mastectomy, which we call "pan-cake method". The purpose of this study is to evaluate the results of our method for the treatment of gynecomastia. Methods: 16 patients from 16 to 31 years of age having gynecomastia were operated using the pan-cake method. 11 patients were in grade I, and 5 patients were in grade II, no patient were in grade III or IV, according to Rod's classification. The pan-cake method started with modified periareolar incision. We executed subcutaneous dissection first and suprafascial dissection next. After dividing the breast into four equal quadrants, we removed breast tissue from each quadrant as necessary. The operation time for the resection was recorded and the weight of removed parenchyme tissues was measured. Results: All the operations were successful. There were no asymmetries, contour deformities, or irregularities. Only 6 cases needed the combined therapy with ultrasound-assisted liposuction(UAL) because of the step deformities. The average operation time was 24.1 minutes and the average weight of removed breast tissue was 98.1g. All the patients were satisfied with the aesthetic results. Conclusion: We concluded that the pan-cake method is an alternative option for the surgical treatment of gynecomastia, giving good aesthetic results and relatively short operation time.

Keywords

References

  1. Yavuz M, Kesiktas E, Kesiktas NN, Acarturk S: Lighted retractor-assisted transaxillary approach in gynecomastia correction. Ann Plast Surg 57: 370, 2006 https://doi.org/10.1097/01.sap.0000222567.04635.3b
  2. Rohrich RJ, Ha RY, Kenkel JM, Adams WP: Classification and management of gynecomastia: defining the role of ultrasound-assisted liposuction. Plast Reconstr Surg 111: 909, 2003 https://doi.org/10.1097/01.PRS.0000042146.40379.25
  3. Wiesman IM, Lehman JA Jr, Parker MG, Tantri MD, Wagner DS, Pedersen JC: Gynecomastia: an outcome analysis. Ann Plast Surg 53: 97, 2004 https://doi.org/10.1097/01.sap.0000116256.01831.17
  4. Hodgson EL, Fruhstorfer BH, Malata CM: Ultrasonic liposuction in the treatment of gynecomastia. Plast Reconstr Surg 116: 646, 2005 https://doi.org/10.1097/01.prs.0000173441.57812.e8
  5. Celebioglu S, Ertas NM, Ozdil K, Oktem F: Gynecomastia treatment with subareolar glandular pedicle. Aesthetic Plast Surg 28: 281, 2004 https://doi.org/10.1007/s00266-004-1300-1
  6. Prado AC, Castillo PF: Minimal surgical access to treat gynecomastia with the use of a power-assisted arthroscopic-endoscopic cartilage shaver. Plast Reconstr Surg 115: 939, 2005 https://doi.org/10.1097/01.PRS.0000153237.35202.7D
  7. Smoot EC 3rd: Eccentric skin resection and purse-string closure for skin reduction with mastectomy for gynecomastia. Ann Plast Surg 41: 378, 1998 https://doi.org/10.1097/00000637-199810000-00005
  8. Kim J, Kim IG, Choi HY, Lew JM: Cases of gynecomastia caused by chromosomal anomaly. J Korean Soc Plast Reconstr Surg 17: 1151, 1990
  9. Liebau J, Machens HG, Berger A: Gynecomastia of the male nipple. Ann Plast Surg 40: 678, 1998 https://doi.org/10.1097/00000637-199806000-00021
  10. Prado AC, Castillo PF: Minimal surgical access to treat gynecomastia with the use of a power-assisted arthroscopic-endoscopic cartilage shaver. Plast Reconstr Surg 115: 939, 2005 https://doi.org/10.1097/01.PRS.0000153237.35202.7D
  11. Chiu DT, Siegel HW: The pinwheel technique: an adjunct to the periareolar approach in gynecomastia resection. Ann Plast Surg 42: 465, 1999 https://doi.org/10.1097/00000637-199905000-00001
  12. Morselli PG: "Pull-through": a new technique for breast reduction in gynecomastia. Plast Reconstr Surg 97: 450, 1996 https://doi.org/10.1097/00006534-199602000-00028