Background: Gynecomastia is an abnormal and benign
enlargement of male breast tissue. It occurs as a result of an
imbalance between estrogen and androgen levels that may be
due to a physiological or pathological cause. Multiple surgical
approaches have been recommended to manage this problem.
It is widely accepted that liposuction solely or when combined
with subcutaneous mastectomy is effective for the management
of low to intermediate grades of gynecomastia. However,
liposuction along with subcutaneous mastectomy gives unsatisfactory
results in high grades where there is excess redundant
skin that needs excision. Several skin incisions have been mentioned
in literature for excision of excess skin, however, some
of these are accompanied by unaesthetic scars.
Objective: To assess the outcome of surgical correction of
high grades of gynecomastia in a single-stage procedure.
Patients and Methods: We conducted a prospective analysis
on 20 patients with grades IIb or III gynecomastia who underwent
single-stage procedures. Photographs were clinically
evaluated by two independent surgeons with respect to chest
contour, symmetry, scar, and residual ptosis. Patient satisfaction
was surveyed regarding chest contour and scar appearance.
Results: Statistical analysis revealed a significant improvement
in patient's clinical measurements after operation,
good doctor's scoring and patient satisfaction scoring among
studied cases, and accepted complication rates.
Conclusions: The current approach eliminates the need for
skin resection in a second surgery, permits immediate skin recontouring,
and achieves an acceptable aesthetic scar.