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Evaluation of Surgical Techniques in Gynecomastia Treatment: Analysis of 65 Cases

Year 2020, , 96 - 100, 30.08.2020
https://doi.org/10.18678/dtfd.681998

Abstract

Aim: Gynecomastia is a benign enlargement of the breast in males. Surgical treatment options include liposuction, glandular excision and the combination of liposuction and glandular excision. In this study, it was aimed to evaluate 65 consecutive gynecomastia patients who were operated using different techniques and to present the treatment approach, and results and complications related to surgical techniques.
Material and Methods: Sixty five patients who underwent gynecomastia operation in our clinic between June 2016 and January 2019 were included in this study. Demographic data, preoperative and postoperative photographs, clinical classification, perioperative details, postoperative results and complications were evaluated retrospectively.
Results: Fifty five (84.6%) patients had bilateral gynecomastia and 10 (15.4%) patients had unilateral gynecomastia. Of the 120 breasts operated, 91 (75.8%) were Grade II, 20 (16.7%) were Grade III and 9 (7.5%) were Grade I, according to the Simon classification. Twenty-eight (43.1%) patients underwent liposuction and glandular excision, 35 (53.8%) patients underwent liposuction alone, and two (3.1%) patients underwent glandular excision only. Skin excision was performed for two patients at the first operation. Only two patients, one for inadequate reduction and the other for skin excess, were demanded revision surgery.
Conclusion: Surgical treatment options for gynecomastia patients can be determined according to clinical evaluation of breast tissue and skin excess. In young patients with good skin quality, skin excision can be left for a second session. Although there was no significant difference between the methods used in this study, more complications were found with the excisional technique.

References

  • 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.
  • Ridha H, Colville RJI, Vesely MJJ. How happy are patients with their gynaecomastia reduction surgery. J Plast Reconstr Aesthet Surg. 2009;62(11):1473-8.
  • Kinsella C Jr, Landfair A, Rottgers SA, Cray JJ, Weidman C, Deleyiannis FWB, et al The psychological burden of idiopathic adolescent gynecomastia. Plast Reconstr Surg. 2012;129(1):1-7.
  • Innocenti A, Melita D, Francesco M, Francesco C, Innocenti M. Management of gynecomastia in patients with different body types: Considerations on 312 consecutive treated cases. Ann Plast Surg. 2017;78(5):492-6.
  • Bannayan GA, Hajdu SI. Gynecomastia: Clinicopathologic study of 351 cases. Am J Clin Pathol. 1972;57(4):431-7.
  • Rohrich RJ, Ha RY, Kenkel JM, Adams WP Jr. Classification and management of gynecomastia: Defining the role of ultrasound-assisted liposuction. Plast Reconstr Surg. 2003;111(2):909-23.
  • Cuhaci N, Polat SB, Evranos B, Ersoy R, Cakir B. Gynecomastia: clinical evaluation and management. Indian J Endocrinol Metab. 2016;18(2):150-8.
  • Prezioso D, Piccirillo G, Galasso R, Altieri V, Mirone V, Lotti T. Gynecomastia due to hormone therapy for advanced prostate cancer: A report of ten surgically treated cases and a review of treatment options. Tumori. 2004;90(4):410-5.
  • Courtiss EH. Gynecomastia: Analysis of 159 patients and current recommendations for treatment. Plast Reconstr Surg. 1987;79(5):740-53.
  • Hodgson ELB, Fruhstorfer BH, Malata CM. Ultrasonic liposuction in the treatment of gynecomastia. Plast Reconstr Surg. 2005;116(2):646-53.
  • Asfuroğlu Barutca S, Kutlu N, Uscetin I, Egemen O, Aksan T, Askeroglu U. Gynecomastia treatment principles: Evaluation of our results. Eur Arc Med Res. 2011;27(1):36-43.
  • Ersoz H, Onde ME, Terekeci H, Kurtoglu S, Tor H. Causes of gynaecomastia in young adult males and factors associated with idiopathic gynaecomastia. Int J Androl. 2002;25(5):312-6.
  • Johnson RE, Murad MH. Gynecomastia: pathophysiology, evaluation, and management. Mayo Clin Proc. 2009;84(11):1010-5.
  • Boljanovic S, Axelsson CK, Elberg JJ. Surgical treatment of gynecomastia: liposuction combined with subcutaneous mastectomy. Scand J Surg. 2003;92(2):160-2.
  • Petty PM, Solomon M, Buchel EW, Tran NV. Gynecomastia: Evolving paradigm of management and comparison of techniques. Plast Reconstr Surg. 2010;125(5):1301-8.
  • Fodor PB, Vogt PA. Power-assisted lipoplasty (PAL): A clinical pilot study comparing PAL to traditional lipoplasty (TL). Aesthetic Plast Surg. 1999;23(6):379-85.
  • Scuderi N, Paolini G, Grippaudo FR, Tenna S. Comparative evaluation of traditional, ultrasonic, and pneumatic assisted lipoplasty: Analysis of local and systemic effects, efficacy, and costs of these methods. Aesthetic Plast Surg. 2000;24(6):395-400.
  • Braunstein GD. Gynecomastia. N Engl J Med 1993;328(7):490-5.
  • Lista F, Ahmad J. Power-assisted liposuction and the pull-through technique for the treatment of gynecomastia. Plast Reconstr Surg. 2008;121(3):740-7.
  • Hammond DC, Arnold JF, Simon AM, Capraro PA. Combined use of ultrasonic liposuction with the pull-through technique for the treatment of gynecomastia. Plast Reconstr Surg. 2003;112(3):891-7.
  • Bracaglia R, Fortunato R, Gentileschi S, Seccia A, Farallo E. Our experience with the so-called pull-through technique combined with liposuction for management of gynecomastia. Ann Plast Surg. 2004;53(1):22-6.

Jinekomasti Tedavisinde Cerrahi Tekniklerin Değerlendirilmesi: 65 Olgunun Analizi

Year 2020, , 96 - 100, 30.08.2020
https://doi.org/10.18678/dtfd.681998

Abstract

Amaç: Jinekomasti erkeklerde görülen iyi huylu meme büyümesidir. Cerrahi tedavi seçenekleri arasında liposakşın, glandüler eksizyon ve liposakşın ve glandüler eksizyon kombinasyonu yer almaktadır. Bu çalışmada farklı teknikler kullanılarak ameliyat edilen ardışık 65 jinekomasti hastasının değerlendirilmesi, tedavi yaklaşımının ve cerrahi tekniklerle ilgili sonuçların ve komplikasyonların sunulması amaçlanmıştır.
Gereç ve Yöntemler: Bu çalışmaya Haziran 2016 ve Ocak 2019 arasında kliniğimizde jinekomasti ameliyatı yapılan 65 hasta dahil edildi. Demografik veriler, preoperatif ve postoperatif fotoğraflar, klinik sınıflandırma, perioperatif detaylar, postoperatif sonuçlar ve komplikasyonlar retrospektif olarak değerlendirildi.
Bulgular: Elli beş (%84,6) hastada iki taraflı jinekomasti ve 10 hastada (%15,3) tek taraflı jinekomasti vardı. Simon sınıflamasına göre, ameliyat edilen toplam 120 memenin 91 (%75,8)’i Evre II, 20 (%16,7)’si Evre III ve 9 (%7,5)’u Evre I idi. Yirmi sekiz (%43,1) hastaya liposakşın ve glandüler eksizyon uygulandı, 35 (%53,8) hastaya sadece liposakşın yapıldı ve 2 (%3,1) hastaya sadece glandüler eksizyon uygulandı. İlk ameliyatta iki hastaya deri eksizyonu yapıldı. Biri yetersiz küçültme ve diğeri ciltte fazlalığı için olmak üzere sadece iki hasta revizyon cerrahisi talep etti.
Sonuç: Jinekomasti hastalarında meme dokusunun klinik değerlendirilmesine ve cilt fazlalığı derecesine göre cerrahi tedavi seçeneği belirlenebilir. Genç hastalarda deri kalitesi iyi ise cilt fazlalığı olsa dahi cilt ekzisyonu ikinci bir seansa bırakılabilir. Bu çalışmada kullanılan yöntemler arasında anlamlı bir fark olmamasına rağmen, eksizyonel teknikte daha fazla sayıda komplikasyon görülmüştür.

References

  • 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.
  • Ridha H, Colville RJI, Vesely MJJ. How happy are patients with their gynaecomastia reduction surgery. J Plast Reconstr Aesthet Surg. 2009;62(11):1473-8.
  • Kinsella C Jr, Landfair A, Rottgers SA, Cray JJ, Weidman C, Deleyiannis FWB, et al The psychological burden of idiopathic adolescent gynecomastia. Plast Reconstr Surg. 2012;129(1):1-7.
  • Innocenti A, Melita D, Francesco M, Francesco C, Innocenti M. Management of gynecomastia in patients with different body types: Considerations on 312 consecutive treated cases. Ann Plast Surg. 2017;78(5):492-6.
  • Bannayan GA, Hajdu SI. Gynecomastia: Clinicopathologic study of 351 cases. Am J Clin Pathol. 1972;57(4):431-7.
  • Rohrich RJ, Ha RY, Kenkel JM, Adams WP Jr. Classification and management of gynecomastia: Defining the role of ultrasound-assisted liposuction. Plast Reconstr Surg. 2003;111(2):909-23.
  • Cuhaci N, Polat SB, Evranos B, Ersoy R, Cakir B. Gynecomastia: clinical evaluation and management. Indian J Endocrinol Metab. 2016;18(2):150-8.
  • Prezioso D, Piccirillo G, Galasso R, Altieri V, Mirone V, Lotti T. Gynecomastia due to hormone therapy for advanced prostate cancer: A report of ten surgically treated cases and a review of treatment options. Tumori. 2004;90(4):410-5.
  • Courtiss EH. Gynecomastia: Analysis of 159 patients and current recommendations for treatment. Plast Reconstr Surg. 1987;79(5):740-53.
  • Hodgson ELB, Fruhstorfer BH, Malata CM. Ultrasonic liposuction in the treatment of gynecomastia. Plast Reconstr Surg. 2005;116(2):646-53.
  • Asfuroğlu Barutca S, Kutlu N, Uscetin I, Egemen O, Aksan T, Askeroglu U. Gynecomastia treatment principles: Evaluation of our results. Eur Arc Med Res. 2011;27(1):36-43.
  • Ersoz H, Onde ME, Terekeci H, Kurtoglu S, Tor H. Causes of gynaecomastia in young adult males and factors associated with idiopathic gynaecomastia. Int J Androl. 2002;25(5):312-6.
  • Johnson RE, Murad MH. Gynecomastia: pathophysiology, evaluation, and management. Mayo Clin Proc. 2009;84(11):1010-5.
  • Boljanovic S, Axelsson CK, Elberg JJ. Surgical treatment of gynecomastia: liposuction combined with subcutaneous mastectomy. Scand J Surg. 2003;92(2):160-2.
  • Petty PM, Solomon M, Buchel EW, Tran NV. Gynecomastia: Evolving paradigm of management and comparison of techniques. Plast Reconstr Surg. 2010;125(5):1301-8.
  • Fodor PB, Vogt PA. Power-assisted lipoplasty (PAL): A clinical pilot study comparing PAL to traditional lipoplasty (TL). Aesthetic Plast Surg. 1999;23(6):379-85.
  • Scuderi N, Paolini G, Grippaudo FR, Tenna S. Comparative evaluation of traditional, ultrasonic, and pneumatic assisted lipoplasty: Analysis of local and systemic effects, efficacy, and costs of these methods. Aesthetic Plast Surg. 2000;24(6):395-400.
  • Braunstein GD. Gynecomastia. N Engl J Med 1993;328(7):490-5.
  • Lista F, Ahmad J. Power-assisted liposuction and the pull-through technique for the treatment of gynecomastia. Plast Reconstr Surg. 2008;121(3):740-7.
  • Hammond DC, Arnold JF, Simon AM, Capraro PA. Combined use of ultrasonic liposuction with the pull-through technique for the treatment of gynecomastia. Plast Reconstr Surg. 2003;112(3):891-7.
  • Bracaglia R, Fortunato R, Gentileschi S, Seccia A, Farallo E. Our experience with the so-called pull-through technique combined with liposuction for management of gynecomastia. Ann Plast Surg. 2004;53(1):22-6.
There are 21 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Muhammed Beşir Öztürk 0000-0002-8977-3741

Cengiz Ertekin 0000-0003-4610-3219

Tolga Aksan 0000-0002-3328-2652

Uğur Kaan Kalem This is me 0000-0002-6291-3978

Mustafa Tezcan This is me 0000-0002-3609-3312

Publication Date August 30, 2020
Submission Date January 29, 2020
Published in Issue Year 2020

Cite

APA Öztürk, M. B., Ertekin, C., Aksan, T., Kalem, U. K., et al. (2020). Evaluation of Surgical Techniques in Gynecomastia Treatment: Analysis of 65 Cases. Duzce Medical Journal, 22(2), 96-100. https://doi.org/10.18678/dtfd.681998
AMA Öztürk MB, Ertekin C, Aksan T, Kalem UK, Tezcan M. Evaluation of Surgical Techniques in Gynecomastia Treatment: Analysis of 65 Cases. Duzce Med J. August 2020;22(2):96-100. doi:10.18678/dtfd.681998
Chicago Öztürk, Muhammed Beşir, Cengiz Ertekin, Tolga Aksan, Uğur Kaan Kalem, and Mustafa Tezcan. “Evaluation of Surgical Techniques in Gynecomastia Treatment: Analysis of 65 Cases”. Duzce Medical Journal 22, no. 2 (August 2020): 96-100. https://doi.org/10.18678/dtfd.681998.
EndNote Öztürk MB, Ertekin C, Aksan T, Kalem UK, Tezcan M (August 1, 2020) Evaluation of Surgical Techniques in Gynecomastia Treatment: Analysis of 65 Cases. Duzce Medical Journal 22 2 96–100.
IEEE M. B. Öztürk, C. Ertekin, T. Aksan, U. K. Kalem, and M. Tezcan, “Evaluation of Surgical Techniques in Gynecomastia Treatment: Analysis of 65 Cases”, Duzce Med J, vol. 22, no. 2, pp. 96–100, 2020, doi: 10.18678/dtfd.681998.
ISNAD Öztürk, Muhammed Beşir et al. “Evaluation of Surgical Techniques in Gynecomastia Treatment: Analysis of 65 Cases”. Duzce Medical Journal 22/2 (August 2020), 96-100. https://doi.org/10.18678/dtfd.681998.
JAMA Öztürk MB, Ertekin C, Aksan T, Kalem UK, Tezcan M. Evaluation of Surgical Techniques in Gynecomastia Treatment: Analysis of 65 Cases. Duzce Med J. 2020;22:96–100.
MLA Öztürk, Muhammed Beşir et al. “Evaluation of Surgical Techniques in Gynecomastia Treatment: Analysis of 65 Cases”. Duzce Medical Journal, vol. 22, no. 2, 2020, pp. 96-100, doi:10.18678/dtfd.681998.
Vancouver Öztürk MB, Ertekin C, Aksan T, Kalem UK, Tezcan M. Evaluation of Surgical Techniques in Gynecomastia Treatment: Analysis of 65 Cases. Duzce Med J. 2020;22(2):96-100.