A Single-Center Experience With Gynecomastia Treatment Using Liposuction, Complete Gland Removal, and Nipple Areola Complex Lifting Plaster Technique: A Review of 448 Patients.

Background: Gynecomastia is defined as a benign enlargement of male breast glandular tissue. It is the most common breast condition in male, and the prevalence ranges from 32% to 72%. No standardized treatment exists for gynecomastia. Objectives: The authors treat gynecomastia patient with liposuction and complete gland excision through periareolar incision without skin excision. In case of skin redundancy, the authors use their special technique called nipple areola complex (NAC) plaster lift technique. Methods: The authors conducted the retrospective analysis of patient who underwent gynecomastia surgery between January 2020 and December 2021 at Chennai Plastic Surgery. All patients were treated with liposuction, gland excision, and NAC lifting plaster when required. The follow-up period ranges from 6 to 14 months. Results: A total of 448 patients (896 breasts) were included in our study with average age of 26.6 years. Grade II gynecomastia was most common in our study. The average BMI of the patients was 27.31 kg/m2. One hundred and sixteen patients (25.9%) experienced some form of complication. Seroma was most common complications in our study followed by superficial skin necrosis. Patient satisfaction rate was high in our study. Conclusions: Gynecomastia surgery is safe and highly rewarding procedure for surgeons. Various technologies and methods like liposuction, complete gland excision, and NAC lifting plaster technique should be adopted in gynecomastia treatment to give a better patient satisfaction. Complications are common in gynecomastia surgery but easily manageable.

Novel Technique for Obtaining Aesthetic Results in Multiple Lipomatosis Surgery.

Multiple lipomatosis is often perceived as a cosmetically disfiguring condition' and therefore' patients seek treatment. Multiple lipomas are commonly treated with excision or liposuction or a combination of both. To obtain a better aesthetic result, various modifications of the above have been tried, like using remote small incision, squeeze delivery technique' and endoscopic-assisted removal. We have used a combination of the above techniques, with the aim of removing the maximum number of lipomas with fewer and smaller incisions. The ultimate outcome is that the patient has a less scarred body. Methods: This is a nonrandomized uncontrolled case series, conducted over 3 years from 2018 to 2021. It included all patients with visible multiple lipomas over upper limbs, lower limbs, chest, abdomen, and back. A total of 30 patients were operated on. The technique used in all patients was liposuction, limited incisions, tunneling, and squeezing out the lipomas. The patients were regularly followed up for 6 months. Result: Lipomas of various sizes were removed by the above mentioned technique. Early postoperative period bruising was noted in seven cases which needed no intervention. Two patients had hematoma collection and one seroma, which was managed with aspiration. Among the 30 patients, 90% were pleased with the cosmetic result' and recurrence was seen in five cases. Conclusions: Our modified technique of treating multiple lipomatosis gives a good aesthetic result and high patient satisfaction for a short-term study. However, comparable and long-term studies need to be performed for more conclusive results.

NAC Plaster Lifting Technique for the Management of Skin Redundancy in Severe Gynecomastia.

Gynecomastia is found to be a common cosmetic problem. Many techniques are currently available for the surgical treatment of gynecomastia, reported to be effective, with limited scar formation. The main objective of our unique reproducible nipple-areola complex (NAC) lifting technique is the management of skin redundancy in severe gynecomastia and positioning the NAC at an aesthetically pleasing site on the chest, for men. Methods: A retrospective study was conducted in 30 gynecomastia surgeries of grade III and IV done from January 2019 to December 2020. All these patients were treated by using the NAC lifting technique in our centre, and the results were assessed with patient and surgeon satisfaction scores. This lifting plaster technique is used after the skin closure of the Webster incision. The U slit in the lifting plaster prevents the wrinkling of the NAC and also avoids the second stage surgery for most of the cases of severe gynecomastia. Results: A retrospective analysis showed that all patients were satisfied with the technique and none of the patients returned for the second stage surgery. Minimal residual skin redundancy was observed, but it was not severe to necessitate a secondary procedure. All patients were satisfied and comfortable with the final outcome.There was no incidence of contour deformity after the procedure. Conclusion: This technique takes advantage of the elastic recoiling property of the skin and helps in re-draping the redundant skin on the chest wall and in positionining the NAC at an aesthetically pleasing position on the chest.