Abstract
Purpose: Gynecomastia is an abnormal increase in the volume of the male breast. Patients affected by gynecomastia with significant glandular enlargement may respond to suction alone and/or sharp dissection and excision. The purpose of this report is to introduce the indications and results of authors' two techniques. Methods: The diameter of parenchyme was determined by a pinch test after liposuction. For the parenchymal diameter less than 4 cm, ultrasound-assisted liposuction was performed, in conjunction with the "pull-out technique" to effectively remove the fibrofatty tissue of the male breast through a single 5-7 mm incision. For the parenchymal diameter more than 4 cm, ultrasound-assisted liposuction and excision were applied through 2.5 cm periareolar approach. Results: A total of 94 patients (185 breasts) underwent the operation from October 2000 to October 2003 and mean follow-up period was 12 months. The volume of aspirates ranged from 50 to 450 cc per breast. There were no major complications such as skin flap necrosis. Five reoperations were performed for 1 hypertrophic scar, 2 under-resected and 2 hematoma cases. The patient's satisfaction was high and most of them were pleased with the shape of the breasts and scars. Conclusion: These procedures can minimize scars and reduce the incidence of contour problem such as saucer deformity, and provides consistent results. Patients can return to full activities in 48 hours. It can be offered as an option for the treatment of gynecomastia.