title: Minimally invasive excision of gynaecomastia--a novel and effective surgical technique.
abstract: BACKGROUND
  More aesthetically acceptable treatment options have been sought to minimise the morbidity associated with open surgery for gynaecomastia. This study investigated the use of a vacuum-assisted biopsy device (VABD) and liposuction to provide minimally invasive approach.
  
  
  METHODS
  Patients diagnosed with idiopathic benign gynaecomastia referred to the Breast Care Unit of Castle Hill Hospital between June 2002 and April 2007 and requesting surgical intervention underwent VABD excision and liposuction. All patients underwent thorough investigations to exclude any underlying cause for their gynaecomastia. The procedure was carried out by a single consultant surgeon with special interest in breast surgery. An 8-G mammotome probe was advanced through a 4-mm incision positioned in the corresponding anterior axillary line to excise the glandular disc. Liposuction was performed through the same incision. Incision wounds were closed with Steristrips. A pressure dressing was applied over wound by corset and an inflatable device.
  
  
  RESULTS
  Thirty-six male patients with grade I and II gynaecomastia were recruited (22 bilateral, 14 unilateral). Average age was 33.3 years (range, 16-88 years). All underwent mammotome excision and liposuction. There were no conversions to an open procedure. The average procedure time was 50.3 min (range, 30-80 min). One intra-operative complication was recorded. The minimum follow-up time was 2 months. Thirty-four patients reported excellent satisfaction, two patients had residual gynaecomastia and needed a re-do procedure. Three patients developed small haematomas that resolved spontaneously.
  
  
  CONCLUSIONS
  This novel, minimally invasive, surgical approach for gynaecomastia gives excellent results with minimal morbidity.
authors.affiliation: Academic Surgical Unit, University of Hull, Cottingham, UK.
authors.forename: O
authors.initials: O
authors.lastname: Qutob
authors.forename: B
authors.initials: B
authors.lastname: Elahi
authors.forename: V
authors.initials: V
authors.lastname: Garimella
authors.forename: N
authors.initials: N
authors.lastname: Ihsan
authors.forename: P J
authors.initials: PJ
authors.lastname: Drew
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000295:instrumentation; D005500:Follow-Up Studies; D006177:Gynecomastia / Q000601:surgery*; D006801:Humans; D015187:Lipectomy / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome; D014618:Vacuum; D055815:Young Adult