YAG Laser Versus Ultrasound Assisted Liposuction in the Management of Grade II Gynecomastia (Comparative Study)

Setta, Hany S; Reyad, Khaled A; AlMahmoudy, Niveen F

doi:10.21608/ejprs.2020.68198

YAG Laser Versus Ultrasound Assisted Liposuction in the Management of Grade II Gynecomastia (Comparative Study)

Document Type : Original Article

Authors

The Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

10.21608/ejprs.2020.68198

Abstract

Introduction: Gynecomastia is a common condition encountered
nowadays. Many surgical treatment options are
available yet the best modality is still controversial. ND: YAG
laser assisted and ultrasound (VASER) assisted liposuction
are well defined and respected tools for liposuction yet no
one proved to be superior over the other. This study's proposal
is to compare the post-operative results for patients treated
with both modalities concerning the complications and patient
satisfaction.
Patients and Methods: Patients with gynecomastia (grade
2) were randomly divided to ND: YAG laser liposuction (group
1) and ultrasound assisted (VASER) liposuction (group 2),
where liposuction zones were marked in all patients. Complications
and satisfaction scores were recorded and statistically
analyzed.
Results: Twenty patients were in this study; 10 in each
group. The median satisfaction score for laser assisted group
was 4.5 while for ultrasound group was 3.4.
Conclusion: Both ND: YAG laser and VASER are powerful
tools in management of gynecomastia (grade 2) with more
satisfaction and less complications in the laser group.

Keywords

Gynecomastia – ND – YAG laser – VASER

Main Subjects

Aesthetics

References

1- Lista F. and Ahmad J.: Gynecomastia. In: Spear SL, Willey
S.C., Robb G.L.E., et al. (Eds.): Surgery of The Breast:
Principles and Art (3rd Edn), Lippincott Williams &
Wilkins; Philadelphia, 1205-10, 2011.
2- Cohen I.K., Pozez A.L. and Mckeown J.E.: Gynecomastia.
In E. Fl. Courtiss (Ed): Male Aesthetic Surgery. St. Louis:
Mosby, 1991.
3- Yordanov Y., Shef A. and Hristoskova R.: Albena Fakirova
Post-Traumatic Onset of Secondary Progression of Gynecomastia.
Eur. J. Plast. Surg., 39 (5): 387-90, 2016.
4- Simon B.E., Hoffman S. and Kahn S.: Classification and
surgical correction of gynecomastia. Plastic and Reconstructive
Surgery, 51 (1): 48-52, 1973.
5- Rohrich R.J., Ha R.Y., Kenkel J.M. and Adams W.P.:
Classification and Management of Gynecomastia: Defining
the Role of Ultrasound-Assisted Liposuction. Plast. Reconstr.
Surg., 111 (2): 909-23, 2003.
6- Adriana C. and Francesco M.: Algorithm for clinical
evaluation and surgical treatment of gynecomastia. Journal
Plastic, Reconstructive & Aesthetic Surgery, 61: 4149,
2008.
7- American Society of Plastic Surgeons, 2017: Plastic
surgery statistics report. Available at: https: //www. plasticsurgery.
org/documents/News/Statistics/2017/plasticsurgery-
statistics-full-report-2017.pdf. Accessed August
3, 2018.
8- Bembo S.A. and Carlson H.E.: Gynecomastia: Its Features,
and When and How to Treat It. Cleveland Clinic Journal
of Medicine, 71: 511-7, 2004.
9- Webster J.P.: Mastectomy for Gynecomastia Through a
Semicircular Intra-areolar Incision. Ann. Surg., 124 (3):
557-75, 1946.
10- Teimourian B. and Perlman R.: Surgery for gynecomastia.
Aesthetic Plast. Surg., 7 (3): 155-7, 1983.
11- Caridi and Robert C.: Defining the Aesthetic Units of the
Male Chest and How They Relate to Gynecomastia Based
on 635 Patients. Plastic and Reconstructive Surgery, 142
(4): 904-7, 2018.
12- Rho Y.K., Kim B.J., Kim M.N., Kang K.S. and Han H.J.:
Laser lipolysis with pulsed 1064nm Nd:YAG laser for
the treatment of gynecomastia. Int. J. Dermatol., 48 (12):
1353-9, 2009.
13- Zocchi M.L.: Ultrasonic liposculpturing. Aesthetic Plast.
Surg., 16: 287-98, 1992.
14- Anderson R.C., Cunningham B., Tafesse E. and Lenderking
W.R.: Validation of the breast evaluation questionnaire
for use with breast surgery patients. Plast. Reconstr. Surg.,
118 (3): 597-602, 2006.
15- Kasielska A. and Antoszewski B.: Effect of operative
treatment on psychosocial problems of men with gynecomastia.
Pol. Przegl. Chir., 83: 614-21, 2011.
16- Fagerlund A., Lewin R., Rufolo G., Elander A., Santanelli
Di Pompeo F. and Selvaggi G.: Gynecomastia: A systematic
review. J. Plast. Surg. Hand Surg., 49: 311-8, 2015.
17- Robert C. Caridi, M.D.: Defining the Aesthetic Units of
the Male Chest and How They Relate to Gynecomastia
Based on 635 Patients. Plast. Reconstr. Surg., 142: 904,
2018.
18- Hoyos A. and Perez M.: Dynamic- definition male pectoral
reshaping and enhancement in slim athletic, obese and
gynecomastia patients through selective fat removal and
grafting. Aesthetic Plastic Surgery, 36 (5): 1066-77, 2012.
19- Teimourian B. and Pearlman R.: Surgery for gynecomastia.
Aesthetic Plast. Surg., 7: 155-7, 1983.
20- Silberg B.N.: The technique of external ultrasound-assisted
lipoplasty. Plast. Reconstr. Surg., 101 (2): 552, 1998.
21- Fodor P.B. and Vogt P.A.: Power-assisted lipoplasty (PAL):
A clinical pilot study comparing PAL to traditional lipoplasty
(TL). Aesthetic Plast. Surg., 23 (6): 379-85, 1999.
22- Zocchi M.L.: Ultrasonic liposculpturing. Aesthetic Plast.
Surg., 16: 287-98, 1992.
23- Maxwell G.P. and Gingrass M.K.: Ultrasound-assisted
lipoplasty: A clinical study of 250 consecutive patients.
Plast. Reconstr. Surg., 101 (1): 189-202, 1998.
24- Zocchi M.L.: Ultrasonic-assisted lipectomy. Adv. Plast.
Reconstr. Surg., 11: 197, 1995.
25- Apfelberg D.: Laser-assisted liposuction may benefit
surgeons and subjects. Clin. Laser Mon., 10: 259, 1992.
26- McBean J. and Katz B.: Laser lipolysis: An update. J
Clinical Aesth. Dermato., 4 (7): 25-34, 2011.
27- Yasser Abdallah Aboelatta and Mohammed Mahmoud
Abdelaal: Comparison of laser-assisted liposuction and
traditional liposuction combined with endoscopic surgical
excision of grade II gynecomastia, Eur. J. Plast. Surg.,
40: 541-8, 2017.
28- Rho Y.K., Kim B.J., Kim M.N., Kang K.S. and Han H.J.:
Laser lipolysis with pulsed 1064nm Nd: YAG laser for
the treatment of gynecomastia. Int. J. Dermatol., 48 (12):
1353-9, 61, 2009.
29- Trelles M.A., Mordon S.R., Bonanad E., et al.: Laserassisted
lipolysis in the treatment of gynecomastia: A
prospective study in 28 patients. Lasers Medical Science,
28 (2): 375-82, 2013.
30- Islam Abdelrahman, Ingrid Steinvall, Bassem Mossaad,
474 Vol. 43, No. 3 / YAG Laser Versus Ultrasound Assisted Liposuction in the Management
Folke Sjoberg and Moustafa Elmasry: Evaluation of
Glandular Liposculpture as a Single Treatment for Grades
I and II Gynaecomastia Aesth. Plast. Surg., 42: 1222-30,
2018.
31- Zukowski M.L. and Ash K.: Ultrasound-assisted lipoplasty
learning curve. Aesthet. Surg. J., 18 (2): 104-10,
1998.
32- Illouz Y.G.: Complications of liposuction. Clin. Plast.
Surg., 33 (1): 129-63, 2006.