Benign disorders of the male breast

Webster, David

doi:10.1007/bf01658422

Cited by 10 publications

(3 citation statements)

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“…Three main surgically relevant classification systems have been described to categorize gynecomastia: Webster's, Simon's, and Rohrich's. Based on tissue type (presence of glandular vs fatty tissue; Table 1), Webster's classification describes three main categories 8,[9][10][11] : Type I identifies mainly glandular tissue present; Type II includes a mix of fatty and glandular tissue; and Type III has mainly simple fatty tissue present. 4 This classification is of importance when considering surgical modality, as will be discussed.…”

Section: Introductionmentioning

confidence: 99%

“…[12][13][14] The second classification, Simon's, delineates grades of gynecomastia with additional subcategories, including amount of tissue and excess skin (Table 2). 4,8,11,15,5 Grade I reflects no skin redundancy/excess and minor breast enlargement. Grade IIa indicates no skin redundancy/excess and with moderate breast enlargement; however, if skin excess/redundancy is present, then it is Grade IIb.…”

Section: Introductionmentioning

confidence: 99%

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Case Report: The TRTMI Procedure, a Novel Surgical Technique for Gynecomastia

Nashed¹,

Branman²

2020

Am J Cosmet Surg

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Gynecomastia presents the most common breast issue in men. It is defined as benign proliferation and enlargement of male breast glandular tissue that distributes most prevalently among neonates, adolescents, and elderly men. With a prevalence of over 60% in the male population, various classifications and treatment options have emerged to address male gynecomastia. Surgical treatment presents challenges and is used when gynecomastia has been present for several years or if medical therapy has been unsuccessful. We attempt to address some of these surgical challenges as they relate to aesthetic goals by presenting our surgical technique. Our surgical technique, the Tissue Resection Through Minimal Incision method, is described with illustrations included. Surgical candidates are selected after a review of the patient’s history, a thorough physical evaluation, obtaining any necessary imaging, and a detailed discussion with the patient. A hybrid, minimally invasive, and direct excision technique is used, including both standard VASER liposuction and direct glandular tissue resection via only a single 3-mm, well-hidden incision using simple instruments readily available with reproducible outcomes. We stress the idea of tissue inversion being key to make this feasible. Several case examples are presented with before and after comparisons, demonstrating good aesthetic results and skin retraction. In the more than 80 cases performed, one patient presented with dusky nipple areolar complex in the recovery room, which resolved with topical nitroglycerin. No nipple areolar complex necrosis occurred, nor hospitalizations were required for the cases performed. A few cases of tissue edema and swelling occurred correlating with inadequate compression or strenuous activity. Incisions were well hidden and aesthetically pleasing to patients. We briefly review gynecomastia classification and treatment options focused on surgical approaches. Of the various surgical methods available to treat gynecomastia, limitations and challenges include unfavorable scar and risk profiles, as well as inadequacy of tissue resection with the minimally invasive techniques. To meet this unmet need, our patented Tissue Resection Through Minimal Incision technique offers a novel minimally invasive approach that includes adequate tissue excision while maximizing aesthetic results and with nominal scarring. There is great need in surgical treatment of gynecomastia to minimize incisions and improve outcomes. Glandular tissue excision is a challenge to the cosmetic profile because of incisions used. Our novel technique and benefits involved address those concerns. However, our procedure does not address gynecomastia cases with excessive skin redundancy that requires excision. Further studies are still needed to address such challenges regarding aesthetic profile goals.

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Section: Introductionmentioning

confidence: 99%