title: Assessment of a suction-assisted cartilage shaver plus liposuction for the treatment of gynecomastia.
abstract: BACKGROUND
  The development of feminized breasts in men may cause significant emotional distress and embarrassment, particularly in young men and adolescents. Numerous techniques have been described for the correction of gynecomastia, many of which include the removal of fat and glandular tissue.
  
  
  OBJECTIVE
  The authors assess the utility of combining vibroliposuction with the use of a power-assisted arthroscopic-endoscopic cartilage shaver to correct gynecomastia and suggest a treatment algorithm for patients with gynecomastia.
  
  
  METHODS
  Forty consecutive patients with a median age of 32 years (range 19-57 years) and with varying degrees of gynecomastia underwent a combined approach that included vibroliposuction (power-assisted tumescent liposuction) for the removal of fatty tissue, followed by the removal of fibrous tissue with the use of a power-assisted cartilage shaver. Follow-up periods ranged in duration from six to 18 months.
  
  
  RESULTS
  All patients had satisfactory results. However, expansive hematomas requiring surgical drainage developed in three patients. Other complications included one case of insufficient resection requiring reoperation and three cases of hyperpigmentation and skin irregularities in patients with grade I gynecomastia.
  
  
  CONCLUSIONS
  Combination treatment using vibroliposuction and a power-assisted arthroscopic-endoscopic cartilage shaver is an effective treatment for gynecomastia, but the technique has a learning curve. This procedure is most appropriate for patients with grades II and III gynecomastia, or as a first-stage treatment for patients with grade IV gynecomastia.
authors.affiliation: Antiaging Group Barcelona, Institut Dexeus, Barcelona, Spain. drbenito@cirugia-estetica.com
authors.forename: Jesús
authors.initials: J
authors.lastname: Benito-Ruiz
authors.forename: Mauricio
authors.initials: M
authors.lastname: Raigosa
authors.forename: Marisa
authors.initials: M
authors.lastname: Manzano
authors.forename: Laura
authors.initials: L
authors.lastname: Salvador
mesh_terms: D000328:Adult; D020679:Arthroscopes; D002356:Cartilage / Q000601:surgery; D003238:Connective Tissue / Q000601:surgery*; D006177:Gynecomastia / Q000601:surgery*; D006801:Humans; D015187:Lipectomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D016462:Mammaplasty / Q000009:adverse effects / Q000295:instrumentation*; D008875:Middle Aged; D017060:Patient Satisfaction; D018579:Patient Selection; D012720:Severity of Illness Index; D013812:Therapeutics; D013997:Time Factors; D014732:Vibration; D055815:Young Adult