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ORIGINAL ARTICLE
Year : 2015  |  Volume : 34  |  Issue : 3  |  Page : 170-176

Liposuction excision of gynecomastia through an axillary liposuction opening: A novel technique


Department of General Surgery, Faculty of Medicine, Minoufiya University, Minoufiya, Egypt

Correspondence Address:
Hady S Abou Ashour
Department of General Surgery, Faculty of Medicine, Minoufiya University, Minoufiya
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-1121.163122

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Introduction Gynecomastia has a negative impact on male self-esteem and social health. In the absence of a medically treatable condition, surgery is the only effective treatment. Treatment includes either liposuction, excision of male breast gland, or both. Excision of the breast tissue is usually performed through a circumareolar incision, which could be a site of infection, unsightly scar, nipple, areola inversion, or necrosis. Aim This study aimed to evaluate the outcome of liposuction excision of gynecomastia through a small axillary approach. Patients and methods One hundred and forty-three patients with gynecomastia, through the period from March 2010 to March 2014, in Minoufiya university hospital and other private hospitals were included in this study; their mean age was 24.3 years. After clinical and laboratory evaluation, liposuction and excision of glandular tissue was performed through the same stab of liposuction at the midaxillary line in the fifth or sixth intercostal spaces under general or local anesthesia; liposuction was first performed using the tumescent technique and then the glandular disc was released from its deep attachments and from subcutaneous and nipple attachments by scissors. Then, drains were inserted through the same liposuction excision opening and pressure bandage and garments were applied. Results One hundred and thirty-four (93.7%) patients showed satisfactory results after 6 months and 138 (96.5%) patients were satisfied with the results after 1 year in terms of proper symmetry and sound healing. One hundred and fifteen patients (80.4%) underwent surgery under general anesthesia and 28 patients (19.5%) underwent surgery under tumescent local anesthesia; the mean operative time was 55 min, the mean hospital stay was 9.6 h, and the average period off work was 5 days. Four patients (2.8%) showed unilateral hematoma formation, none of the patients showed saucer dish deformity, areola, nipple necrosis, or inversion, one patient (0.6%) developed a unilateral wound infection, two patients (1.4%) showed seroma formation, and two patients (1.4%) showed skin laxity. Conclusion The axillary liposuction excision technique was associated with very good esthetic results for both fibrous and fatty gynecomastia, with little complications.


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