Vacuum-assisted minimally invasive surgery—An innovative method for the operative treatment of gynecomastia

Yao, Yu; Yang, Yi; Liu, Jiawei; Wang, Yue; Zhao, Yang

doi:10.1016/j.surg.2019.04.032

Cited by 15 publications

(12 citation statements)

References 22 publications

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“…The majority of authors specifically listed standard use of drain placement in all patients regardless of surgical technique, with the exception of Wyrick et al (who reported drain usage based on surgeon preference), Li et al (who did not utilize drain placement in patients with grade I gynecomastia who received SSPM ± liposuction), and Shirol, Khalil et al, Coskun et al, Sim et al, and Akhtar et al (who did not routinely utilize drain placement in any patients). 8 , 9 , 17 , 20 , 23 , 24 , 26 – 31 …”

Section: Resultsmentioning

confidence: 99%

“…Transient NAC hypoesthesia was not considered a major complication for the purpose of this study; however, of those articles that reported NAC hypoesthesia occurrence (6), the rate ranged from 3% to 19.2%. 8 , 17 , 19 , 23 , 24 , 26 Revision rate was specifically reported by 8 authors and ranged from 0% to 14.1%. 8 , 9 , 19 , 20 , 23 , 26 , 29 , 31 Hematoma was the most often cited major complication occurring in 5.8% of cases, which is consistent with what has been previously stated in the literature (4.6%).…”

Section: Resultsmentioning

confidence: 99%

“…VAM for treatment of gynecomastia used a 3-mm incision at the intersection between the mid-axillary and trans-areolar lines. 8 A dilute epinephrine solution was infiltrated into the tissue via this incision followed by insertion of a vacuum-assisted rotation needle into the posterior space between the superficial fascia of the pectoralis major muscle and the breast tissue. This technique has been primarily used for breast mass biopsy but has been adopted by Yao et al 8 for the treatment of gynecomastia across all Simon grades.…”

Section: Discussionmentioning

confidence: 99%

“… 8 A dilute epinephrine solution was infiltrated into the tissue via this incision followed by insertion of a vacuum-assisted rotation needle into the posterior space between the superficial fascia of the pectoralis major muscle and the breast tissue. This technique has been primarily used for breast mass biopsy but has been adopted by Yao et al 8 for the treatment of gynecomastia across all Simon grades. Similarly to VAM, MELT, as described by Sim et al, 31 uses a microdebrider for removal of breast tissue; however, their preferred location for incision lies within the NAC due to the tendency for hypertrophic scarring in their specific patient population.…”

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: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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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“…In the last few years, the use of vacuum-assisted devices, originally created to diagnose breast lesions by radiologicallyguided procedures, has shown to be promising in the surgical management of GM [8][9][10][11][12] .…”

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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The Vacuum-Assisted Breast Biopsy System is an Effective Strategy for the Treatment of Gynecomastia

Zhang

et al. 2020

Aesth Plast Surg

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Vacuum-assisted minimally invasive surgery—An innovative method for the operative treatment of gynecomastia

Cited by 15 publications

References 22 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

The Vacuum-Assisted Breast Biopsy System is an Effective Strategy for the Treatment of Gynecomastia

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