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

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.

Keywords

• gynecomastia
• liposuction
• surgery

Jinekomasti Tedavisinde Cerrahi Tekniklerin Değerlendirilmesi: 65 Olgunun Analizi

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.

Keywords

• Jinekomasti
• liposakşın
• cerrahi

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