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A Single-Center Experience With Gynecomastia Treatment Using Liposuction, Complete Gland Removal, and Nipple Areola Complex Lifting Plaster Technique: A Review of 448 Patients (2023)
Karthik Ramasamy, DNB; Sanjib Tripathee, MD;
Anitha Murugesh, DNB; Joyce Jesudass, MCh;
Rakesh Sinha, MCh; and Abisshek Raj Alagarasan, MBBS
Abstract
Background
Gynecomastia is defined as a benign enlargement of male breast glandular tissue. It is the most common breast condition in males, and the prevalence ranges from 32% to 72%. No standardized treatment exists for gynecomastia.
Objectives
The authors treat gynecomastia patients with liposuction and complete gland excision through the periareolar incision without skin excision. In the case of skin redundancy, the authors use their special technique called the nipple-areola complex (NAC) plaster lift technique.
Methods
The authors conducted a retrospective analysis of patients who underwent gynecomastia surgery between January 2020 and December 2021 at Chennai Plastic Surgery. All patients were treated with liposuction, gland excision, and NAC lifting plaster when required. The follow-up period ranges from 6 to 14 months.
Results
A total of 448 patients (896 breasts) were included in our study with an average age of 26.6 years. Grade II gynecomastia was the most common in our study. The average BMI of the patients was 27.31 kg/m2. One hundred and sixteen patients (25.9%) experienced some form of complication. Seroma was the most common complication in our study followed by superficial skin necrosis. The patient satisfaction rate was high in our study.
Conclusions
Gynecomastia surgery is a safe and highly rewarding procedure for surgeons. Various technologies and methods like liposuction, complete gland excision, and NAC lifting plaster technique should be adopted in gynecomastia treatment to give better patient satisfaction. Complications are common in gynecomastia surgery but easily manageable.
Gynecomastia is defined as benign enlargement of male breast glandular tissue. The term “gynecomastia” originates from the Greek word “Gyne” meaning female and “mastos” meaning breast. It usually occurs bilaterally, but in some cases, it can occur unilaterally.1 It is the most common breast condition in males, with a prevalence ranging from 32% to 72%.2 Gynecomastia is caused due to increased ratio of estrogen to androgen production. Estrogen acts as a growth hormone that increases the size of the male breast. The causes of gynecomastia are unknown in 25% of cases.3 Similarly, around 10% to 25% of cases of gynecomastia are associated with drugs like spironolactone, ketoconazole, and calcium channel blocker.4
Gynecomastia is often asymptomatic, but breast pain or tenderness may be present in some cases. Many patients with enlarged breasts are affected psychologically, which has not been extensively studied.5 It might cause anxiety, reduced self-esteem, embarrassment, and depression. This issue should be addressed properly during consultation. Medical treatment of gynecomastia is not successful to date. Different surgical options exist for gynecomastia including liposuction, limited access excision, skin-sparing mastectomy, mastectomy with skin resection, and breast amputation with free nipple transfer.6
CONCLUSIONS
Gynecomastia surgery is a safe and highly rewarding procedure for surgeons. No standardized treatment exists for gynecomastia. Various technologies and methods like liposuction, complete gland excision, and NAC lifting plaster technique should be adopted in gynecomastia treatment for better patient satisfaction. Complications are common in gynecomastia surgery but easily manageable.
Karthik Ramasamy, DNB; Sanjib Tripathee, MD;
Anitha Murugesh, DNB; Joyce Jesudass, MCh;
Rakesh Sinha, MCh; and Abisshek Raj Alagarasan, MBBS
Abstract
Background
Gynecomastia is defined as a benign enlargement of male breast glandular tissue. It is the most common breast condition in males, and the prevalence ranges from 32% to 72%. No standardized treatment exists for gynecomastia.
Objectives
The authors treat gynecomastia patients with liposuction and complete gland excision through the periareolar incision without skin excision. In the case of skin redundancy, the authors use their special technique called the nipple-areola complex (NAC) plaster lift technique.
Methods
The authors conducted a retrospective analysis of patients who underwent gynecomastia surgery between January 2020 and December 2021 at Chennai Plastic Surgery. All patients were treated with liposuction, gland excision, and NAC lifting plaster when required. The follow-up period ranges from 6 to 14 months.
Results
A total of 448 patients (896 breasts) were included in our study with an average age of 26.6 years. Grade II gynecomastia was the most common in our study. The average BMI of the patients was 27.31 kg/m2. One hundred and sixteen patients (25.9%) experienced some form of complication. Seroma was the most common complication in our study followed by superficial skin necrosis. The patient satisfaction rate was high in our study.
Conclusions
Gynecomastia surgery is a safe and highly rewarding procedure for surgeons. Various technologies and methods like liposuction, complete gland excision, and NAC lifting plaster technique should be adopted in gynecomastia treatment to give better patient satisfaction. Complications are common in gynecomastia surgery but easily manageable.
Gynecomastia is defined as benign enlargement of male breast glandular tissue. The term “gynecomastia” originates from the Greek word “Gyne” meaning female and “mastos” meaning breast. It usually occurs bilaterally, but in some cases, it can occur unilaterally.1 It is the most common breast condition in males, with a prevalence ranging from 32% to 72%.2 Gynecomastia is caused due to increased ratio of estrogen to androgen production. Estrogen acts as a growth hormone that increases the size of the male breast. The causes of gynecomastia are unknown in 25% of cases.3 Similarly, around 10% to 25% of cases of gynecomastia are associated with drugs like spironolactone, ketoconazole, and calcium channel blocker.4
Gynecomastia is often asymptomatic, but breast pain or tenderness may be present in some cases. Many patients with enlarged breasts are affected psychologically, which has not been extensively studied.5 It might cause anxiety, reduced self-esteem, embarrassment, and depression. This issue should be addressed properly during consultation. Medical treatment of gynecomastia is not successful to date. Different surgical options exist for gynecomastia including liposuction, limited access excision, skin-sparing mastectomy, mastectomy with skin resection, and breast amputation with free nipple transfer.6
CONCLUSIONS
Gynecomastia surgery is a safe and highly rewarding procedure for surgeons. No standardized treatment exists for gynecomastia. Various technologies and methods like liposuction, complete gland excision, and NAC lifting plaster technique should be adopted in gynecomastia treatment for better patient satisfaction. Complications are common in gynecomastia surgery but easily manageable.
