title: Gynecomastia: Simultaneous Subcutaneous Mastectomy and Areolar Reduction with Minimal Inconspicuous Scarring.
abstract: Acceptable scar positioning on the anterior male chest is very limited. In Gynecomastia surgery, an obvious areolar incision is the most sensitive indicator of a previous operation; a less apparent scar is indispensable for the patient's psychological satisfaction. Whenever only areolar diameter reduction is required, the circumareolar incision must be performed in a position leaving the least conspicuous scar. Standard excision of an outer doughnut of areolar skin results in a visible and unnatural peri-areolar scar. The peri-nipple excision of areolar skin leaves the skin-areola junction undisturbed. When combined with a transverse areolar infra-nipple incision, access for subcutaneous mastectomy is facilitated. With this approach, risk of nipple vascular compromise is thought to be reduced, and necrosis of areolar pigmented skin virtually impossible.
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authors.affiliation: Division of Plastic & Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon. batiyeh@terra.net.lb.
authors.forename: Bishara S
authors.initials: BS
authors.lastname: Atiyeh
authors.affiliation: Division of Plastic & Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon. fmchahine@msn.com.
authors.forename: Fadel
authors.initials: F
authors.lastname: Chahine
authors.affiliation: Division of Plastic & Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Arij
authors.initials: A
authors.lastname: El-Khatib
authors.affiliation: Division of Plastic & Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Hamed
authors.initials: H
authors.lastname: Janom
authors.affiliation: Division of Plastic & Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Nazareth
authors.initials: N
authors.lastname: Papazian
mesh_terms: D000328:Adult; D002921:Cicatrix / Q000517:prevention & control; D006177:Gynecomastia / Q000601:surgery*; D006801:Humans; D008297:Male; D015414:Mastectomy, Subcutaneous / Q000379:methods*; D009558:Nipples / Q000601:surgery*
keywords: Breast; Gynecomastia; Liposuction; Mega-areola; Peri-nipple incision