title: No-Drain Single Incision Liposuction Pull-Through Technique for Gynecomastia.
abstract: BACKGROUND
  Several different methods have been proposed for treatment of gynecomastia, depending on the amount of breast enlargement and skin redundancy. The liposuction pull-through technique has been proposed as an efficacious treatment for many gynecomastia cases. This work aims to study the outcome of this technique when applied as an outpatient procedure, without the use of drains and through a single incision.
  
  
  METHODS
  Fifty-two patients with bilateral gynecomastia without significant skin excess were included in this study. The liposuction pull-through technique was performed through a single incision just above the inframammary fold and without the use of drains. Patients were followed up for 6 months.
  
  
  RESULTS
  The proposed technique was able to treat the gynecomastia in all patients, with a revision rate of 1.9% to remove residual glandular tissues. There were no seromas, hematomas, nipple distortion, permanent affection of nipple sensation or wound healing problems.
  
  
  CONCLUSIONS
  The liposuction pull-through technique is an effective treatment for gynecomastia without significant skin redundancy. It combines the benefits of the direct excision of glandular tissues, with the minimally invasive nature of liposuction. Performing the procedure through a single incision without the use of drains and without general anesthesia is a safe alternative.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Cairo University Hospitals, Cairo, Egypt.
authors.forename: Ashraf A
authors.initials: AA
authors.lastname: Khalil
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Cairo University Hospitals, Cairo, Egypt.
authors.forename: Amr
authors.initials: A
authors.lastname: Ibrahim
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Cairo University Hospitals, Cairo, Egypt. ahafifi@yahoo.com.|Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin Hospital and Clinics, 600 Highland Avenue; G5/361 Clinical Science Center, Mail Code 3236, Madison, WI, 53792, USA. ahafifi@yahoo.com.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Afifi
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D004322:Drainage / Q000295:instrumentation; D006177:Gynecomastia / Q000601:surgery*; D006801:Humans; D015187:Lipectomy / Q000379:methods*; D008297:Male; D000072836:Surgical Wound
keywords: Gynecomastia; Pull-through; Single puncture