Backgrounds: Many surgical techniques have been described
for management of grade III gynecomastia. Nippleareola
complex (NAC) free transfer, inferior and superior
pedicle techniques have been published in the literatures for
treatment of grade III gynecomastia. In order to reduce the
excess skin, all theses techniques leave acceptable scars.
Original postero-inferior technique was described to improve
the aesthetic outcome with preserving the neurovascular
pedicle of the areola. This technique maintains the sensitivity
and vitality of the new areola, but post-operative rates of
breast contour and NAC were still not satisfactory. In this
study, we described a new modified postero-inferior technique
and compared its functional and aesthetic outcomes to that
of the original technique.
Aim of this Study: Is to compare the functional and aesthetic
outcomes as well as patients' satisfaction of the original
and modified postero-inferior pedicle techniques in patients
with grade III gynecomastia.
Patients and Methods: 12 adult patients suffering from
grade III gynecomastia were included in this cohort prospective
study. Patients were treated surgically by modified posteroinferior
technique. Post-operative aesthetic and functional
outcomes, as well as patients' satisfaction were evaluated by
patients' questionnaires and compared to that of the original
technique.
Results: In comparison to the original technique, aesthetic
outcome of modified technique showed more patient satisfaction
as regards chest contour (Q1) and NAC rating (Q2) with
the same rate of patients' satisfaction as regards functional
outcomes (nipple sensitivity and parathesia) also both techniques
showed postoperative intact vascularity of the new
NAC. Rate of complications decreased from 33% in the
original technique to 16.7% in the modified technique with
100% post-operative rate of NAC symmetry.
Conclusion: The new modified postero-inferior technique
improves the post-operative aesthetic outcomes as well as it
preserves the same functional outcomes, if compared with
that of the original technique.