title: Cryolipolysis for Targeted Fat Reduction and Improved Appearance of the Enlarged Male Breast.
abstract: BACKGROUND
  Pseudogynecomastia refers to benign male breast enlargement due to excess subareolar fat. Standard treatment is surgical excision under general anesthesia, liposuction, or a combination of both.
  
  
  OBJECTIVE
  The safety and efficacy of cryolipolysis was investigated for nonsurgical treatment of pseudogynecomastia.
  
  
  METHODS
  Enrollment consisted of 21 males with pseudogynecomastia. Subjects received a first treatment consisting of a 60-minute cryolipolysis cycle, followed by a two-minute massage, and a second 60-minute cycle with 50% treatment area overlap. At 60 days of follow-up, subjects received a second 60-minute treatment. Safety was evaluated by monitoring side effects and adverse events. Efficacy was assessed by ultrasound, clinical photographs, and subject surveys.
  
  
  RESULTS
  Surveys revealed that 95% of subjects reported improved visual appearance and 89% reported reduced embarrassment associated with pseudogynecomastia. Ultrasound showed mean fat layer reduction of 1.6 ± 1.2 mm. Blinded reviewers correctly identified 82% of baseline photographs. Side effects included mild discomfort during treatment and transient paresthesia and tenderness. One case of paradoxical hyperplasia (PH) occurred but likelihood of PH in the male breast is not believed to be greater than in any other treatment area.
  
  
  CONCLUSIONS
  This study demonstrated feasibility of cryolipolysis for safe, effective, and well-tolerated nonsurgical treatment of pseudogynecomastia.
authors.affiliation: *Dermatology, Laser, and Vein Specialists of the Carolinas, Charlotte, North Carolina; †Department of Dermatology, Wake Forest University, Winston Salem, North Carolina; ‡Department of Medicine, UNC School of Medicine, Carolinas Medical Center, Charlotte, North Carolina; §Division of Dermatology, Department of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Girish S
authors.initials: GS
authors.lastname: Munavalli
authors.forename: Ratchathorn
authors.initials: R
authors.lastname: Panchaprateep
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D017679:Cryotherapy / Q000379:methods*; D006177:Gynecomastia / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D015187:Lipectomy / Q000379:methods*; D008297:Male; D008405:Massage; D008875:Middle Aged; D017060:Patient Satisfaction; D016896:Treatment Outcome; D014463:Ultrasonography