Endoscopic subcutaneous mastectomy plus liposuction via a si
Most techniques for surgical correction of gynecomastia are performed by anterior and/or lateral chest incisions, showing an “operated” appearance. The initial experience was introduced in gynecomastia with a combination of endoscopic subcutaneous mastectomy and liposuction via an axillary single incision.

A series of 45 male patients who had Simon grade I or II gynecomastia were enrolled in this study. The demographics, operative data, and postoperative complications were recorded in detail. Four independent observers gave their ratings by assigning scores of 1 to 5 for 6 main aesthetic aspects based on pre and postoperative photographs.

Endoscopic subcutaneous mastectomy combined with liposuction via an axillary single incision was performed successfully in all cases.

- Mean operative duration was 82.6 minutes for each side. The weight of the resected glandular tissue of the 89 breasts was 26 to 130 g and the aspiration volume was 60 to 700 mL.

- Three unilateral subcutaneous seromas, 5 unilateral hematomas, and 1 bilateral minimal skin redundancy were encountered.

- Observer-reported outcomes indicated that patients with grade ? gynecomastia had significantly better aesthetic results than those with grade ?b in the aspects of symmetry, shape of nipple, shape of areola, contour regularity, and overall appearance.

- Patients with grade ?a gynecomastia also witnessed better improvement than grade ?b in shape of nipple, contour regularity, and overall appearance.

Conclusively, endoscopic subcutaneous mastectomy combined with liposuction via an axillary single incision is a feasible minimally invasive technique for the treatment of gynecomastia. The combined method is effective in achieving satisfied aesthetic results for Simon grades I and ?a gynecomastia, and it can also be an alternative choice for grade ?b.

Surgery
Source: https://doi.org/10.1016/j.surg.2021.01.046
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