Year 2020, Volume 22 , Issue 1, Pages 17 - 22 2020-04-30

Liposuction ile Jinekomasti Tedavisi: Klinik Deneyim
Gynecomastia Treatment with Liposuction: Clinical Experience

Ali GÖKKAYA [1] , Metin GÖRGÜ [2] , Burçin ACUNER [3]


Amaç: Jinekomasti fizyolojik, patolojik veya ilaca bağlı nedenlerle erkeklerdeki normal meme dokusunun görünür hale gelecek kadar büyümesidir. Fizyolojik ve patolojik jinekomasti östrojen ile androjen metabolizmasındaki bozulmadan dolayı ortaya çıkmaktadır. İlaca bağlı jinekomasti ise yine bu hormonal metabolizmayı etkileyen hormonlar dışında farklı ilaç gruplarında da yan etki olarak görülebilmektedir. Jinekomasti tedavisinde özellikle erken dönemde medikal tedavi ve neden olabilecek ilaçların kesilmesi, daha ileri dönemlerde ise direkt eksizyon, endoskopik subkutan mastektomi, liposuction yöntemleri ile eksizyon gibi çeşitli yöntemlerle başarılı sonuçlar bildirilmiştir.
Gereç ve Yöntemler: Bu çalışmada Evre I, II ve III hastalarda 3 farklı planda 3 farklı kalınlıkta kanüller ile aspirasyon destekli ıslak liposuction (suction assisted wet liposuction) tekniği ile jinekomasti tedavi sonuçlarımızı sunmaktayız. Bu teknik ile kliniğimizde 2009 ile 2019 arasında 45 hasta opere edilmiştir. Tüm hastalar operasyon sonrasında komplikasyon oranlarının ve nihai estetik sonucun gözlemlenebilmesi için postoperatif dönemde en az 6 ay takip edilmiştir.
Bulgular: Bu çalışmada değerlendirilen 45 hastada komplikasyon oranı %6,7, operasyon başarı oranı %93,3 ve hasta memnuniyeti %91,1 idi. Jinekomasti tedavisinde başta liposuction olmak üzere diğer mevcut tedaviler gözden geçirilmiş ve çalışmamızdaki sonuçlar literatür eşliğinde değerlendirilmiştir.
Sonuç: Jinekomastinin cerrahi tedavisinde mevcut çok sayıda farklı yöntem bulunmaktadır. Bu çalışmada ıslak liposuction yöntemi ile jinekomasti tedavisinde Evre I, II ve III hasta grubunda başarılı sonuçlar elde edildiği ve hasta memnuniyetinin yüksek olduğu gösterilmiştir

Aim: Gynecomastia is the visible enlargement of the male breast tissue either due to physiologic, pathologic or drug-related causes. Physiological and pathological gynecomastia occurs because of the derangement of the estrogen and androgen metabolism. Drug-related gynecomastia is seen when using drugs affecting this hormone metabolism as well as a side effect of different drugs. Successful treatment of gynecomastia was reported with medical treatment and cessation of the possible causative drugs especially in early period, and with direct excision, endoscopic subcutaneous mastectomy and excision with liposuction treatments in the late period.
Material and Methods: In this study, we reported our results of gynecomastia treatment with suction assisted wet liposuction in 3 different planes using 3 different thickness cannulas in Grade I, II and III patients. Forty five patients were operated between 2009 and 2019 using this technique in our clinique. All patients were followed for up to a minimum of 6 months to observe the complication rate and the final aesthetic result.
Results: Within the 45 patients evaluated in this study, the complication rate was 6.7%, the success rate of the operation was 93.3% and the patient satisfaction was 91.1%. Gynecomastia treatment in general -especially liposuction- was reviewed and our results were evaluated based on the literature results.
Conclusion: There are many different options for gynecomastia treatment. In this study, we concluded that in Grade I, II, and III patients good results can be achieved and patient satisfaction is high in gynecomastia treatment with wet liposuction.
  • Blau M, Hazani R, Hekmat D. Anatomy of the gynecomastia tissue and its clinical significance. Plast Reconstr Surg Glob Open. 2016;4(8):e854.
  • Soliman AT, De Sanctis V, Yassin M. Management of adolescent gynecomastia: an update. Acta Biomed. 2017;88(2):204-13.
  • Kanakis GA, Nordkap L, Bang AK, Calogero AE, Bártfai G, Corona G, et al. EAA clinical practice guidelines-gynecomastia evaluation and management. Andrology. 2019;7(6):778-93.
  • Rasko YM, Rosen C, Ngaage LM, AlFadil S, Elegbede A, Ihenatu C, et al. Surgical management of gynecomastia: a review of the current insurance coverage criteria. Plast Reconstr Surg. 2019;143(5):1361-8.
  • Fagerlund A, Lewin R, Rufolo G, Elander A, Santanelli di Pompeo F, Selvaggi G. Gynecomastia: a systematic review. J Plast Surg Hand Surg. 2015;49(6):311-8.
  • Baumann K. Gynecomastia - conservative and surgical management. Breast Care (Basel). 2018;13(6):419-24.
  • Neyzi O, Alp H, Yalcindag A, Yakacikli S, Orphon A. Sexual maturation in Turkish boys. Ann Hum Biol. 1975;2(3):251-9.
  • Güvenç H, Yurdakök M, Kinik E, Büyükgebiz A. The incidence of pubertal gynecomastia in boys living in the Ankara region. Turk J Pediatr. 1989;31(2):123-6.
  • Bailey SH, Guenther D, Constantine F, Rohrich RJ. Gynecomastia management: an evolution and refinement in technique at UT Southwestern Medical Center. Plast Reconstr Surg Glob Open. 2016;4(6):e734.
  • Cordova A, Moschella F. Algorithm for clinical evaluation and surgical treatment of gynaecomastia. J Plast Reconstr Aesthet Surg. 2008;61(1):41-9.
  • Lee YK, Lee JH, Kang SY. Gynecomastia: glandular-liposculpture through a single transaxillary one hole incision. J Plast Surg Hand Surg. 2018;52(2):117-25.
  • Brown RH, Chang DK, Siy R, Friedman J. Trends in the surgical correction of gynecomastia. Semin Plast Surg. 2015;29(2):122-30.
  • Jin Y, Fan M. Treatment of gynecomastia with prednisone: case report and literature review. J Int Med Res. 2019;47(5):2288-95.
  • Collins PS, Moyer KE. Evidence-based practice in liposuction. Ann Plast Surg. 2018;80(6S Suppl 6):S403-5.
  • Khalil AA, Ibrahim A, Afifi AM. No-drain single incision liposuction pull-through technique for gynecomastia. Aesthetic Plast Surg. 2017;41(2):298-303.
  • Hammond DC. Surgical correction of gynecomastia. Plast Reconstr Surg. 2009;124(1 Suppl):61e-8e.
  • Ibrahiem SM. Severe gynecomastia: new technique using superior pedicle NAC flap through a circumareolar approach. Ann Plast Surg. 2016;76(6):645-51.
  • Munavalli GS, Panchaprateep R. Cryolipolysis for targeted fat reduction and improved appearance of the enlarged male breast. Dermatol Surg. 2015;41(9):1043-51.
  • Fischer S, Hirsch T, Hirche C, Kiefer J, Kueckelhaus M, Germann G, et al. Surgical treatment of primary gynecomastia in children and adolescents. Pediatr Surg Int. 2014;30(6):641-7.
  • Abdelrahman I, Steinvall I, Mossaad B, Sjoberg F, Elmasry M. Evaluation of glandular liposculpture as a single treatment for grades I and II gynaecomastia. Aesthetic Plast Surg. 2018;42(5):1222-30.
  • Zavlin D, Jubbal KT, Friedman JD, Echo A. Complications and outcomes after gynecomastia surgery: analysis of 204 pediatric and 1583 adult cases from a national multi-center database. Aesthetic Plast Surg. 2017;41(4):761-7.
  • Varlet F, Raia-Barjat T, Bustangi N, Vermersch S, Scalabre A. Treatment of gynecomastia by endoscopic subcutaneous mastectomy in adolescents. J Laparoendosc Adv Surg Tech A. 2019;29(8):1073-6.
  • Yao Y, Yang Y, Liu J, Wang Y, Zhao Y. Vacuum-assisted minimally invasive surgery-An innovative method for the operative treatment of gynecomastia. Surgery. 2019;166(5):934-9.
Primary Language en
Subjects Medicine
Journal Section Research Article
Authors

Orcid: 0000-0003-2710-9615
Author: Ali GÖKKAYA
Institution: ABANT IZZET BAYSAL UNIVERSITY
Country: Turkey


Orcid: 0000-0001-9077-2976
Author: Metin GÖRGÜ (Primary Author)
Institution: ABANT IZZET BAYSAL UNIVERSITY
Country: Turkey


Orcid: 0000-0001-8728-279X
Author: Burçin ACUNER
Institution: ZONGULDAK BULENT ECEVIT UNIVERSTIY
Country: Turkey


Dates

Publication Date : April 30, 2020

Bibtex @research article { dtfd654652, journal = {Duzce Medical Journal}, issn = {}, eissn = {1307-671X}, address = {}, publisher = {Duzce University}, year = {2020}, volume = {22}, pages = {17 - 22}, doi = {10.18678/dtfd.654652}, title = {Gynecomastia Treatment with Liposuction: Clinical Experience}, key = {cite}, author = {Gökkaya, Ali and Görgü, Metin and Acuner, Burçin} }
APA Gökkaya, A , Görgü, M , Acuner, B . (2020). Gynecomastia Treatment with Liposuction: Clinical Experience . Duzce Medical Journal , 22 (1) , 17-22 . DOI: 10.18678/dtfd.654652
MLA Gökkaya, A , Görgü, M , Acuner, B . "Gynecomastia Treatment with Liposuction: Clinical Experience" . Duzce Medical Journal 22 (2020 ): 17-22 <https://dergipark.org.tr/en/pub/dtfd/issue/53917/654652>
Chicago Gökkaya, A , Görgü, M , Acuner, B . "Gynecomastia Treatment with Liposuction: Clinical Experience". Duzce Medical Journal 22 (2020 ): 17-22
RIS TY - JOUR T1 - Gynecomastia Treatment with Liposuction: Clinical Experience AU - Ali Gökkaya , Metin Görgü , Burçin Acuner Y1 - 2020 PY - 2020 N1 - doi: 10.18678/dtfd.654652 DO - 10.18678/dtfd.654652 T2 - Duzce Medical Journal JF - Journal JO - JOR SP - 17 EP - 22 VL - 22 IS - 1 SN - -1307-671X M3 - doi: 10.18678/dtfd.654652 UR - https://doi.org/10.18678/dtfd.654652 Y2 - 2020 ER -
EndNote %0 Düzce Tıp Fakültesi Dergisi Gynecomastia Treatment with Liposuction: Clinical Experience %A Ali Gökkaya , Metin Görgü , Burçin Acuner %T Gynecomastia Treatment with Liposuction: Clinical Experience %D 2020 %J Duzce Medical Journal %P -1307-671X %V 22 %N 1 %R doi: 10.18678/dtfd.654652 %U 10.18678/dtfd.654652
ISNAD Gökkaya, Ali , Görgü, Metin , Acuner, Burçin . "Gynecomastia Treatment with Liposuction: Clinical Experience". Duzce Medical Journal 22 / 1 (April 2020): 17-22 . https://doi.org/10.18678/dtfd.654652
AMA Gökkaya A , Görgü M , Acuner B . Gynecomastia Treatment with Liposuction: Clinical Experience. Duzce Medical Journal. 2020; 22(1): 17-22.
Vancouver Gökkaya A , Görgü M , Acuner B . Gynecomastia Treatment with Liposuction: Clinical Experience. Duzce Medical Journal. 2020; 22(1): 17-22.
IEEE A. Gökkaya , M. Görgü and B. Acuner , "Gynecomastia Treatment with Liposuction: Clinical Experience", Duzce Medical Journal, vol. 22, no. 1, pp. 17-22, Apr. 2020, doi:10.18678/dtfd.654652