Glandular Gynecomastia Excision Through Axillary Incision Following Ultra-Sound Assisted Liposuction (UAL) of the Breast

Maher, Sherif; Al-Dabaani, Waleed; Abd El-Hamed, Ayman

doi:10.21608/ejprs.2018.215060

Glandular Gynecomastia Excision Through Axillary Incision Following Ultra-Sound Assisted Liposuction (UAL) of the Breast

Document Type : Original Article

Authors

The Department of Plastic Surgery, Faculty of Medicine, Fayoum University, Fayoum, Egypt

10.21608/ejprs.2018.215060

Abstract

Background: Gynaecomastia is a medical term meaning
benign enlargement of the male breast due to a physiological
or pathological factor. With a reported prevalence of up to
36%. Male gynaecomastia can be pure, fatty, or mixed. Simon
in 1973 grouped the patients into categories according to the
size of the gynaecomastia and classified gynecomastia into
grades. Rohrich classified gynecomastia according to the
degree of hypertrophy and put different treatment options and
in cases with more than 500gm hypertrophy he suggested
excision and liposuction. The use of ultrasound for cosmetic
surgery has been introduced since the late 1980. UAL delivers
ultrasonic energy directly to deep fat deposits through very
tiny incisions in the skin. This technique enhances the current
procedure in liposuction. Following the liposuction excision
can be done via different approaches to remove the remaining
glandular component of the breast.
Material and Methods: 28 male patients with gynecomastia
were presented in this study, through the period from February
2012 to October 2016, in Fayoum university hospital. First
full detailed history and lab examination was done. The surgery
was done either under local anaesthesia with sedation or under
general anaesthesia .Liposuction was done using UAL first
through anterior axillary incision, and then dissection of the
gland was done using the Laparoscopic Scissors. Excision of
gland was done through the same incision of liposuction at
the axilla. Pressure garments were applied for 4 weeks following
the surgery.
Results: 26 patients (92.8%) showed good satisfactory
results in follow-up period ranging from 6 months to at least
up to 2 years. 20 patients (71.4%) had been operated under
general anaesthesia and 8 patients (28.6%) under local anaesthesia.
The operative time ranged from 1 hour and 15 minutes
to 2 hours with mean operative time 1 hour and 35 minutes.
All the cases were done as a day cases. None of the patients
showed hematomas or seromas or wound infection, one patient
had areola injury healed spontaneously and one patient had
depressed saucer dish deformity.
Conclusion: The UAL and axillary excision of gynecomastia
has excellent results with few complications and safe
procedure and aids to decreasing the skin laxity following the
surgery.

Keywords

Main Subjects

Aesthetics

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