Abstract:

Objective

To explore the treatment effect and cosmetics of “keyholestyle” total removal of the glands for male gynecomastia.

Methods

Nineteen patients with bilateral male gynecomastia including 2 glandular type, 4 fat type and 13 glandular plus fat type, aged 18-28 years (median 22 years), were treated in our hospital. All patients were operated on with the method of “keyhole-style” total removal of the glands. An tumescent anesthesia fluid was delivered to the subcutaneous fat area of the breast enlargement, vacuum aspiration was done through the keyhole incision under the areola to suck the fat tissue in the region, then the hypertrophical breast tissue was excised strip by strip through the same incision. After complete removal of the glands the keyhole incision was closed with medical biological adhesive. Cosmetic effect was scored using the aesthetics evaluation criteria for breast conserving operation.

Results

The operation time was 30 - 125 min (mean,63 min). The intraoperative bleeding was within 30 ml. The maintaining period of postoperative drainage tube was three days (the tube was removed when the daily drainage volume was < 10 ml). The hospitalization period after operation was 2-5 days (mean, 2.8 days). The median follow-up time was 10. 2 (6-15) months. The 19 patients were all successfully treated with the method, and all had healing by first intention and there was no obvious scar. No nipple or areola necrosis was found. The breast curve was flat and natural,and nipple appearance was normal in all patients. Slight pain after operation happened in all patients, only oral analgesics were given. The 19 patients were all satisfied with their breast appearance, and all were scored at more than 10 scores. Good cosmetic effect was obtained.

Conclusion

The method of “keyhole-style” total removal of the glands for male gynecomastia has the advantages of easy operation, safeness, less damage, less bleeding,and quick recovery. It fits all types of gynecomastia.

Key words: gynecomastia, liposuction, surgery