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DOI: 10.1055/s-0045-1802327
Gynecomastia Surgery: Liposuction Alone versus Liposuction with Endoscope-Assisted Glandular Excision—A Comparative Study

Abstract
Background
Gynecomastia, affecting around 30% of young males, has seen evolving surgical treatments, transitioning from traditional excision methods to contemporary techniques like liposuction. Emotional distress persists when glandular tissue is inadequately addressed, prompting exploration of combined liposuction and glandular excision procedures.
Materials and Methods
Patients undergoing gynecomastia surgery over a period of 2 years were assessed, considering their demographics, medical history, and gynecomastia grade. Surgical procedures involved liposuction alone or with glandular excision. Endoscopy was used to assess the presence of fibroglandular tissue and the need for glandular excision. Postoperative assessments, clinical photography, and patient questionnaires spanned a 6-month follow-up.
Results
Thirty-two breasts (17 in liposuction alone and 15 in liposuction with glandular excision groups) were included. Liposuction alone led to bruising and two hematomas, and “puffy nipples” necessitating one redo surgery. Glandular excision resulted in four cases of crater deformity and one case each of superficial skin necrosis, hematoma, and seroma. Cosmetic evaluations showed similar outcomes, with the liposuction alone group having higher redo surgery rates.
Conclusion
This study finds that combining liposuction with glandular excision delivers comparable cosmetic results to liposuction alone for gynecomastia. Despite added complexity, the combined approach proves effective and helps in decision-making, emphasizing the need for tailored techniques and ongoing research to optimize treatment strategies.
Keywords
gynecomastia - liposuction - aesthetic outcomes - peri-areolar glandular excision - patient satisfactionPublikationsverlauf
Artikel online veröffentlicht:
23. Januar 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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References
- 1 Cuhaci N, Polat SB, Evranos B, Ersoy R, Cakir B. Gynecomastia: clinical evaluation and management. Indian J Endocrinol Metab 2014; 18 (02) 150-158
- 2 Lemaine V, Cayci C, Simmons PS, Petty P. Gynecomastia in adolescent males. Semin Plast Surg 2013; 27 (01) 56-61
- 3 Holzmer SW, Lewis PG, Landau MJ, Hill ME. Surgical management of gynecomastia: a comprehensive review of the literature. Plast Reconstr Surg Glob Open 2020; 8 (10) e3161
- 4 Ordaz DL, Thompson JK. Gynecomastia and psychological functioning: a review of the literature. Body Image 2015; 15: 141-148
- 5 Pfeiler PP, Luketina R, Dastagir K. et al. Expected reduction of the nipple-areolar complex over time after treatment of gynecomastia with ultrasound-assisted liposuction mastectomy compared to subcutaneous mastectomy alone. Aesthetic Plast Surg 2021; 45 (02) 431-437
- 6 Ramasamy K, Tripathee S, Murugesh A, Jesudass J, Sinha R, Alagarasan AR. A single-center experience with gynecomastia treatment using liposuction, complete gland removal, and nipple areola complex lifting plaster technique: a review of 448 patients. Aesthet Surg J Open Forum 2023; 5: ojac095
- 7 Abdali H, Rasti M, Adib Parsa M, Seyedipour S, Tavakoli-Fard N. Liposuction versus periareolar excision approach for gynecomastia treatment. Adv Biomed Res 2023; 12 (01) 93
- 8 Asal M, Ewedah M, Bassiony M, Abdelatif A. Liposuction and port site nipple sparing mastectomy: an alternative method for the operative treatment of gynecomastia at Alexandria main university hospital. BMC Surg 2023; 23 (01) 244
- 9 Prasetyono TOH, Budhipramono AG, Andromeda I. Liposuction assisted gynecomastia surgery with minimal periareolar incision: a systematic review. Aesthetic Plast Surg 2022; 46 (01) 123-131
- 10 Caridi RC. Total gynecomastia removal with layered closure: a study of 567 cases. Plast Reconstr Surg Glob Open 2022; 10 (04) e4256
- 11 Innocenti A, Melita D, Dreassi E. Incidence of complications for different approaches in gynecomastia correction: a systematic review of the literature. Aesthetic Plast Surg 2022; 46 (03) 1025-1041
- 12 Arvind A, Khan MAA, Srinivasan K, Roberts J. Gynaecomastia correction: a review of our experience. Indian J Plast Surg 2014; 47 (01) 56-60
- 13 Tarallo M, Di Taranto G, Fallico N, Ribuffo D. The round-the-clock technique for correction of gynecomastia. Arch Plast Surg 2019; 46 (03) 221-227
- 14 Hasanyn MA, Said SMA. One stage ultrasonic-assisted liposculpture combined with peri areolar surgical gland excision without skin resection: can manage sever degrees of glandular gynecomastia?. Egyptian J Plast Reconstr Surg 2022; 46 (04) 355-360
- 15 Esme DL, Beekman WH, Hage JJ, Nipshagen MD. Combined use of ultrasonic-assisted liposuction and semicircular periareolar incision for the treatment of gynecomastia. Ann Plast Surg 2007; 59 (06) 629-634
- 16 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 (05) 1222-1230
- 17 Ridha H, Colville RJI, Vesely MJJ. How happy are patients with their gynaecomastia reduction surgery?. J Plast Reconstr Aesthet Surg 2009; 62 (11) 1473-1478
- 18 Alnaim MF, Alraihan JI, Al Rabiah NM. et al. Quality of life assessment for men with gynecomastia in Saudi Arabia. Cureus 2022; 14 (10) e30925