Análise comparativa da técnica da incisão em duplo círculo com as técnicas com incisão periareolar e transareolomamilar de correção cirúrgica da ginecomastia

Abstract

Análise comparativa da técnica da incisão em duplo círculo com as técnicas com incisão periareolar e transareolomamilar de correção cirúrgica da ginecomastia (p<0,01); houve um caso de infecção com a TAM (11,1%); duas necroses parciais do mamilo com a DC (10,5%); quatro (21,1%) cicatrizes alargadas e três (15,8%) cicatrizes hipertróficas com o DC (p=0,04); uma inversão do mamilo com o TAM (2,4%). COnClusões: a técnica do DC é uma boa opção para correção de ginecomastias volumosas, embora exija maior tempo cirúrgico e apresente mais cicatrizes alargadas. AbstractPuRPOse: to compare the double-circle (DC) technique to other techniques, with periareolar (PA) and transverse nippleareolar (TNA) incisions, for the surgical correction of gynecomastia. MethOds: we studied the medical files of 34 patients from the Federal University of Goiás, submitted to the surgical correction of gynecomastia, from 1999 to 2004. Patients were divided according to the surgical technique used. The parametric numeric variables were compared by Tukey test. The χ 2 or the Fisher's exact test was used for nominal variables. It was considered significant a p value<0.05. Results: the mean age of the patients was 27.9 (+12.5) years. There were 43 gynecomastias, 34 unilateral (79.1%) and nine (20.9%) bilateral. There were 19 breasts operated (44.2%) using DC, 14 (33.6%) using PA incision, and 10 (23.3%), TNA incision. The mean drain usage was five days for DC and one day for the others (p<0.01). The suction drain was used in 19 cases (100%) of DC and two (22%) in TNA. The other patients used drains of Penrose (p<0.01). The mean surgical time was significantly larger for DC (73 minutes) than for PA (45 minutes) and for TNA (48 minutes). DC was used mainly in voluminous gynecomastias (p=0.04). The complications consisted in three (33%) hematomas in TNA (p<0.01) and one (5%) in DC; one (11%) infection in TNA; two (10%) partial necrosis of the nipple in DC; four (21%) enlarged scars in DC (p=0.04); three (16%) hypertrofic scars (p=0.08) in DC; one (2%) inversion of nipple with TNA. COnClusiOns: The DC was used often in voluminous gynecomastias. It was a good and secure operation, although it required a more extensive surgical time and had a larger possibility of distended scars.

Incisão transareolopapilar para mamoplastia de aumento: experiência dos últimos 10 anos do Instituto Ivo Pitanguy

“…Breast augmentation surgery using this incision was proposed at a later date 4 . Other authors have also proposed that this surgical route be used for the performance of other surgical procedures 8 . However, relatively few authors have advocated the use of this access route, principally because of: changes in the areolar-papillary complex; difficult lactation; increase in infection indices; visible and hypopigmented scarring; need for another access route in the case of breast ptosis in the future; and greater incidence of capsular contracture 9 .…”

“…Subsequently, recent studies advocated the use of this access route, stipulating the advantages of performing an incision in the areolar-papillary complex [5][6][7] . The transareolopapilar approach is not restricted to surgery for gynecomastia correction or breast augmentation and can also be used for procedures such as the removal of benign tumors from the breasts 8 . The advantage of this approach is the ease of access it provides to all breast quadrants.…”

“…However, the referred access route has historically been unpopular for breast augmentation surgery with implants since it is associated with difficult lactation, greater rates of capsular contracture, visible scarring, and alterations in the sensitivity of the areolar-papillary complex 9 . Other authors have advocated the use of this access route exclusively for patients with an areola diameter of > 3.5 cm and pronounced breast ptosis 8 . The present study aimed to retrospectively evaluate breast augmentation surgery with implant insertion performed using the transareolopapilar incision at the Ivo Pitanguy Institute over the past 10 years, assessing the quality of scarring and the incidence of postoperative complications.…”