Surgical Management of Gynecomastia: Subcutaneous Mastectomy and Liposuction.
BACKGROUND
The treatment of gynecomastia depends on multiple factors, and the best modality is controversial. In this study, we aimed to determine the best management approach by comparing outcomes of two groups of patients with gynecomastia who received subcutaneous mastectomy combined with liposuction and liposuction only.


METHODS
We conducted a retrospective analysis of 64 patients who underwent surgery for gynecomastia. We divided the patients into two groups: group A, patients who underwent liposuction only; and group B, patients who underwent liposuction and subcutaneous mastectomy. The serial photographs of all patients were clinically evaluated with respect to size, shape, scarring, and overall outcome by three plastic surgeons, and patient satisfaction was surveyed with regard to palpable lumps, size, shape, scarring, and overall outcome.


RESULTS
Of the 64 subjects, 16 received liposuction only, and 48 received the combination procedure. A total of 125 breasts were involved. The doctors' scores for size and overall outcome were significantly better in the combination group, whereas scarring was better in the liposuction-only group. Similarly, patient satisfaction regarding size was significantly higher in the combination group, and satisfaction regarding scarring was significantly higher in the liposuction-only group. The scores for scarring in the combination treatment group were acceptable.


CONCLUSIONS
Our study shows that combination treatment with liposuction and subcutaneous mastectomy results in satisfactory outcomes, including the extent of scarring. We conclude that this combination treatment should be recommended as the standard surgical treatment for gynecomastia and can provide excellent results in cases where glandular tissue needs to be removed.


METHODS
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Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
Dae Hwa
DH
Kim
Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
Il Hwan
IH
Byun
Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
Won Jai
WJ
Lee
Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
Dong Kyun
DK
Rah
Department of Plastic and Reconstructive Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea.
Ji Ye
JY
Kim
Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea. xyphoss@yuhs.ac.
Dong Won
http://orcid.org/0000-0003-0046-3139
DW
Lee
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004954:Esthetics; D006177:Gynecomastia / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D015187:Lipectomy / Q000379:methods*; D008297:Male; D015414:Mastectomy, Subcutaneous / Q000379:methods*; D010361:Patients; D010781:Photography; D012189:Retrospective Studies; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult
Gynecomastia; Liposuction; Subcutaneous mastectomy