Combined use of ultrasonic-assisted liposuction and semicircular periareolar incision for the treatment of gynecomastia.
BACKGROUND
Of the wide range of excisional and liposuction techniques used to correct gynecomastia, so far, no single one was suitable for all grades of gynecomastia. We introduce ultrasonic-assisted liposuction (UAL) combined with conventional liposuction and partial gland resection without skin excision as the standard surgical technique for all such grades.


METHODS
Twenty-eight men (aged 17 to 80 years) were consecutively treated from March 2004 through April 2006 for grade Ia (n = 3), Ib (n = 2), IIa (n = 6), IIb (n = 6), III (n = 8), or IV (n = 3) gynecomastia. Their characteristics and the outcome of surgery were retrospectively assessed.


RESULTS
A mean of 848 mL (range, 300 to 1400 mL) of liquefied breast tissue was aspirated, and 31 g (range, 3 to 180 g) of fibroglandular tissue were excised per breast. No immediate or delayed adjuvant skin reduction was needed in any of the patients. Moderate postoperative ecchymosis was observed in 2 patients, but no complications were encountered in this series. The cosmetic outcome was good to excellent in all.


CONCLUSIONS
UAL in combination with gland resection through a minimal caudal semicircular periareolar incision and conventional liposuction effectively corrects all grades of gynecomastia. This combination has little morbidity, requires no skin excision, and leads to uniformly good esthetic results.
Esme
Danielle L
DL
Department of Plastic and Reconstructive Surgery, County Hospital Hilversum, Hilversum, The Netherlands. danielle_esme@yahoo.com
Beekman
Werner H
WH
Hage
J Joris
JJ
Nipshagen
Martine D
MD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006177:Gynecomastia / Q000601:surgery*; D006801:Humans; D015187:Lipectomy / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014465:Ultrasonics