title: Conventional versus ultrasound-assisted liposuction in gynaecomastia surgery: a 13-year review.
abstract: BACKGROUND
  Numerous surgical techniques exist for gynaecomastia treatment. Although ultrasound-assisted liposuction (UAL) is thought to be more effective than conventional liposuction, to date there remains no objective and direct comparison of the two modalities. Hence, a comparative study was performed of a single surgeon's experience over 13 years using two definitive parameters, namely intraoperative conversion to open excision and postoperative revisional surgery rates.
  
  
  METHODS
  All gynaecomastia patients treated with UAL or conventional liposuction (1999-2012) were retrospectively studied. UAL was only available in the private sector and was used for all such patients with no other selection or exclusion criteria.
  
  
  RESULTS
  A total of 219 patients (384 breasts) with a mean age of 29 years (range 12-74) were evaluated. UAL was utilised in 24% of breasts (47 patients, 91 breasts). Compared with conventional liposuction, UAL had significantly lower rates of intraoperative conversion to open excision (25% vs. 39%; p<0.05) and postoperative revision (2% vs. 19%; p<0.001) using Fisher's exact test. The haematoma rate for each technique was 1%.
  
  
  CONCLUSIONS
  UAL is a more effective treatment modality for gynaecomastia than conventional liposuction as determined by intraoperative conversion to open surgery and subsequent need for revision.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
authors.forename: Kai Yuen
authors.initials: KY
authors.lastname: Wong
authors.affiliation: Department of Plastic and Reconstructive Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Department of Plastic and Reconstructive Surgery, Cambridge Breast Unit at Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Postgraduate Medical Institute, Anglia Ruskin University, Chelmsford and Cambridge, UK. Electronic address: cmalata@hotmail.com.
authors.forename: Charles M
authors.initials: CM
authors.lastname: Malata
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D061887:Conversion to Open Surgery; D006177:Gynecomastia / Q000000981:diagnostic imaging / Q000601:surgery*; D006406:Hematoma / Q000209:etiology; D006801:Humans; D015187:Lipectomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010781:Photography; D012086:Reoperation; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional / Q000295:instrumentation; D055815:Young Adult
keywords: Conventional liposuction; Gynaecomastia; Male cosmetic breast surgery; Suction-assisted lipectomy; Ultrasonic liposuction; Ultrasound-assisted liposuction