title: Power-assisted liposuction and the pull-through technique for the treatment of gynecomastia.
abstract: BACKGROUND
  Gynecomastia is a common condition affecting many adolescent and adult males. Surgical techniques utilizing a variety of incisions, excisions, suction-assisted lipectomy, ultrasound-assisted liposuction, power-assisted liposuction, or some combination of these methods have been used in the treatment of gynecomastia. This article describes the authors' method of using power-assisted liposuction and the pull-through technique to treat gynecomastia.
  
  
  METHODS
  This technique involves the use of power-assisted liposuction to remove fatty breast tissue. The pull-through technique is then performed utilizing several instruments to sever the subdermal attachments of fibroglandular breast tissue; this tissue is removed through the incision used for liposuction. Finally, power-assisted liposuction is performed again to contour the remaining breast tissue. A chart review of 99 consecutive patients (197 breasts) treated between January of 2003 and November of 2006 was performed.
  
  
  RESULTS
  Ninety-six patients (192 breasts) were successfully treated using this technique. Power-assisted liposuction was performed in all cases, and the average volume aspirated per breast was 459 ml (range, 25 to 1400 ml). Using the pull-through technique, the authors were able to remove between 5 and 70 g of tissue per breast. Complications were minimal (1.0 percent of breasts), and no revisions were required.
  
  
  CONCLUSIONS
  Since January of 2003, the authors have used this technique to successfully treat 97 percent of their gynecomastia patients. Combining power-assisted liposuction and the pull-through technique has proven to be a versatile approach for the treatment of gynecomastia and consistently produces a naturally contoured male breast while resulting in a single inconspicuous scar.
authors.affiliation: Mississauga, Ontario, Canada; and Dallas, Texas From the Plastic Surgery Clinic; Division of Plastic Surgery, Trillium Health Center; and Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Frank
authors.initials: F
authors.lastname: Lista
authors.forename: Jamil
authors.initials: J
authors.lastname: Ahmad
mesh_terms: D000293:Adolescent; D000328:Adult; D006177:Gynecomastia / Q000601:surgery*; D006801:Humans; D015187:Lipectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged