Background: Gynecomastia is defined as an excessively
developed male breast to the extent it resembles the female
one. Emotional discomfort and social embracement motivate
the patients to seek a medical advice, to restore the masculine
breast shape. In high grade gynecomastia, the contributing
factors are excess redundant skin, fibro-glandular tissue and
abundant adiposity, each component should be considered
separately in the patient's surgical plan. Various surgical
procedures were succeeded to correct this deformity but with
drawbacks such as residual unsightly scar, or contour irregularities.
Objectives: Were to treat high grades of gynecomastia
with a multifaceted procedure; by combining liposuction,
glandular excision together with excess skin resection through
circumareolar concentric approach.
Aim: This study has evaluated that procedure as regard
technical refinements, early and late complications and aesthetic
outcome.
Method: In this case series, eighteen healthy male patients
who had bilateral gynecomastia, had undergone correction of
their breast deformity with that multifaceted procedure between
January 2016 and June 2017, their ages ranged from [17-
61years old, with mean ± 30.94].
Results: All patients were satisfied with the results except
one patient who had undergone reoperation. The early complication
rate was 27.7%; it was consistent with other series.
The follow-up aesthetic evaluation scale showed that 65% of
patients with very good result, 22% of patients with good
result, 17% patients with average result, and only one patient
had poor result.
Conclusion: This combination had succeeded to address
the contributing causes of severe gynecomastia. The problems
of excess and displaced tissues were properly dealt with
through circumareolar approach to achieve a pleasant scar
confined to the areola with flat male chest