Treatment of Gynecomastia by Endoscopic Subcutaneous Mastectomy in Adolescents

Varlet, François; Raia-Barjat, Tiphaïne; Bustangi, Nasser; Vermersch, Sophie; Scalabre, Aurélien

doi:10.1089/lap.2019.0256

Cited by 20 publications

(18 citation statements)

References 19 publications

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“…A large variety of surgical approaches was also noted for treatment of grade II gynecomasta, including SSPM, SSPM + liposuction, VAM, MELT, ESCM, and MSR. Varlet et al 30 and Fan et al 21 used ESCM for treatment of patients with grade IIb and III gynecomastia via an incision made at the intersection of the mid-axillary and trans-areolar lines. A trocar was then inserted with insufflation of CO 2 at 8 mm Hg of pressure.…”

Section: Discussionmentioning

confidence: 99%

“…Dissection and removal of the breast tissue was conducted with an ultrasonic scalpel or tissue clipper. 21 , 30 Although the techniques described by Varlet et al 30 and Fan et al 31 do not address the excess skin characteristic of grade IIb gynecomastia, this may be a viable alternative for patients who scar poorly or prefer skin redundancy over the presence of visible scars.…”

Section: Discussionmentioning

confidence: 99%

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Surgical Management of Gynecomastia: A Comprehensive Review of the Literature

Holzmer

Lewis

Landau

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Summary: Gynecomastia is a graded condition characterized by enlargement of the male breast that affects a significant proportion of the male population. A plethora of varying surgical approaches currently exists in the literature; thus this comprehensive review sought to analyze surgical practice patterns and trends as they pertain to gynecomastia grade and severity. The current literature was queried utilizing the PubMed and MEDLINE databases—based on predefined parameters and individual review, 17 studies were ultimately included. Key data points included gynecomastia grade, surgical intervention, rate of complication, including hematoma, seroma, infection, and necrosis, and drain use. Two-sample t test was utilized for further analysis. A total of 1112 patients underwent surgical treatment for gynecomastia. Skin-sparing mastectomy with or without liposuction was the most frequently used procedure followed by mastectomy with skin reduction. Major complication rates ranged from 0% to 33%, with hematoma formation being most common (5.8%) followed seroma (2.4%). There was a higher rate of hematoma/seroma formation among authors who routinely utilized drain placement (9.78% versus 8.36%; P = 0.0051); however, this is likely attributable to the large discrepancy in percentage of grade III patients found in each group (50.23% versus 4.36%; P = 0.0000). As a wide variety of surgical techniques exist for the treatment of gynecomastia, an individualized approach based upon gynecomastia grade and patient preference may assist the surgeon in providing optimal outcomes. This senior author’s preferred method for treatment of gynecomastia is illustrated in the included algorithm.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Surgical Management of Gynecomastia: A Comprehensive Review of the Literature

Holzmer

Lewis

Landau

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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“…In order to decrease morbidity and improve esthetic results, the GM treatment should improve with new surgical techniques and minimally invasive procedures. More recently, some groups have described an endoscopeassisted subcutaneous mastectomy 5 , with a smaller incision. However, this technique did not eliminate the potential complication of having a scar on a visible part of the chest or axillae, and the risk of nipple-areola complex complications remains 8 .…”

Section: Discussionmentioning

confidence: 99%

“…Traditional open surgery by semicircular inferior periareolar incision is the most common surgical approach, but it may cause significant morbidities, such as asymmetry, poor scarring, and nipple-areola complex retraction or necrosis [5][6][7] . In order to obtain better esthetic results, some alternatives to open surgery have been proposed, such as liposuction, endoscopic mastectomy, and vacuum-assisted excision (VAE) [7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive treatment of gynecomastia by ultrasound-guided vacuum-assisted excision: report of a case series

Couto¹,

Valadares²,

Pellegrini

et al. 2021

Mastology

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Introduction: Gynecomastia (GM) is a benign proliferation of glandular breast tissue in men. Some cases need surgical intervention. Traditional open surgery by semicircular inferior periareolar incision is the most common surgical approach. In order to obtain better esthetic results, some alternatives to open surgery have been proposed, such as liposuction, endoscopic mastectomy, and vacuum-assisted excision (VAE). Objective: To describe the technical surgical approach of ultrasound-guided VAE of GM and its results from a case series. Method: This is an evaluation of seven GM cases submitted to ultrasound-guided VAE with a 10G needle using the ENCOR® BD whole circumference automated breast biopsy system in Redimasto – Redimama, a Brazilian breast center. The result was considered good or satisfactory when it showed minimal remaining gland, good symmetry, no retraction, necrosis, hypertrophic scar, or displacement of the nipple-areola complex. All patients answered a questionnaire to evaluate their satisfaction and perception of the procedure. Results: Seven (7) patients with Simon grade 1 and 2 bilateral GM underwent ultrasound-guided VAE. No case of displacement, necrosis, or retraction of the nipple-areola complex, post-procedure bleeding, infection, skin necrosis, or asymmetry was detected. No patient reported decrease or change in nipple sensation or erection. All patients had bruises and hematomas that spontaneously resolved within 30 days. All results were considered good or excellent by patients and surgeons. Conclusion: Minimally invasive ultrasound-guided VAE is an excellent alternative for the treatment of GM. It is better indicated for Simon grade 1 and 2 GM, with good and excellent esthetic results, small scar, and low rates of nipple and areolar complications. It allows an outpatient procedure with low morbidity (local anesthesia) and fast recovery.

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“…Surgical treatment can be performed under local anesthesia with sedation, under local anesthesia alone or under general anesthesia (20). Open surgical excision techniques using semicircular periareolar incision have high morbidity (22). Minimally invasive methods include suction assisted liposuction, power assisted liposuction, ultrasound assisted liposuction, laser assisted liposuction and vacuum assisted minimally invasive or endoscopic subcutaneous mastectomy (2,22,23).…”

Section: Surgical Treatmentmentioning

confidence: 99%

Liposuction ile Jinekomasti Tedavisi: Klinik Deneyim

Gökkaya

Görğü

Acuner

2020

Düzce Tıp Fakültesi Dergisi

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Aim: Gynecomastia is the visible enlargement of the male breast tissue either due to physiologic, pathologic or drug-related causes. Physiological and pathological gynecomastia occurs because of the derangement of the estrogen and androgen metabolism. Drug-related gynecomastia is seen when using drugs affecting this hormone metabolism as well as a side effect of different drugs. Successful treatment of gynecomastia was reported with medical treatment and cessation of the possible causative drugs especially in early period, and with direct excision, endoscopic subcutaneous mastectomy and excision with liposuction treatments in the late period. Material and Methods: In this study, we reported our results of gynecomastia treatment with suction assisted wet liposuction in 3 different planes using 3 different thickness cannulas in Grade I, II and III patients. Forty five patients were operated between 2009 and 2019 using this technique in our clinique. All patients were followed for up to a minimum of 6 months to observe the complication rate and the final aesthetic result. Results: Within the 45 patients evaluated in this study, the complication rate was 6.7%, the success rate of the operation was 93.3% and the patient satisfaction was 91.1%. Gynecomastia treatment in general -especially liposuction-was reviewed and our results were evaluated based on the literature results. Conclusion:There are many different options for gynecomastia treatment. In this study, we concluded that in Grade I, II, and III patients good results can be achieved and patient satisfaction is high in gynecomastia treatment with wet liposuction.

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Treatment of Gynecomastia by Endoscopic Subcutaneous Mastectomy in Adolescents

Cited by 20 publications

References 19 publications

Surgical Management of Gynecomastia: A Comprehensive Review of the Literature

Surgical Management of Gynecomastia: A Comprehensive Review of the Literature

Minimally invasive treatment of gynecomastia by ultrasound-guided vacuum-assisted excision: report of a case series

Liposuction ile Jinekomasti Tedavisi: Klinik Deneyim

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