Background: Gynecomastia means abnormal hypertrophy
of the male breast tissue. Gynecomastia is classified into 4
degrees, according to Simon et al., with grade 4 or III being
characterised by marked glandular hypertrophy with skin
excess. There are many procedures that are described in
gynecomastia management as surgical excision, suctionassisted
lipectomy, and ultrasound-assisted liposuction (UAL).
Objectives: In our study, we will manage grade III cases
with UAL only with peri-areolar surgical gland excision
without skin excision procedure.
Patients and Methods: Twenty-five cases were included
in the study in the period from February 2019 to January
2021. It is a prospective study on grade III gynecomastia
cases using UAL only with periareolar surgical gland excision
without skin excision procedure.
Results: The study encountered 25 cases, whose age
ranged between 18 and 32 years old. All cases were grade III
glandular gynecomastia. Operation time was varied, ranging
from 1.5 hours to 2 hours. The amount of liposuction ranged
between 400cc to 1300cc and the weight of the excised gland
was between 20 and 55gm.
Complications: 2 cases revealed seroma, which were
managed by aspiration, and 1 case of saucer shape deformity
due to over excision of reto-areolar glandular tissue. 1 case
suffered from a decrease in nipple sensation which improved
within 4 to 6 months post-operative. These complications
occurred in 2 cases out of the 25 cases, with an overall success
rate of 92%. No hematomas, infections, skin necrosis, asymmetry
or skin redundancy were noticed.
Conclusion: Ultrasonic-assisted liposculpture combined
with periareolar surgical gland excision without skin resection
procedure guarantees safe, effective, and satisfactory results
in managing grade III idiopathic gynecomastia. No or minimal
complications with minimal skin redundancy with good
cosmetic results