Abstract
Gynecomastia is a unilateral or bilateral enlargement of male breast. Many surgical techniques have been proposed depending on the type and severity of the breast deformity. According to the classification by Simon et al., we introduced a modified pull-through technique suitable for I, II, and III grade. With this method, we achieved a good aesthetic result with minimally invasive surgery and at the same time, we obtained complete en bloc removal of the breast gland. From January 2010 to March 2018, 32 gynecomastia patients (ranging from I to III grade of Simon’s classification) were enrolled. Eighteen patients underwent a combined treatment with traditional suction-assisted lipoplasty and en bloc removal of the gland. The other 14 patients were treated with different modalities. Follow-up was performed every week in the first month, then monthly for 3 months, at 6 and 12 months post-op. We obtained complete en bloc removal of gland with satisfactory breast contour for all of the patients; no nipple retraction or altered pigmentation of the skin was observed. Only one patient reported temporary nipple-areola complex (NAC) deformity. Our technique has proven to be successful in the removal of the entire gland en bloc. It respects the anatomical planes and it ensures excellent aesthetic results with minimal complication rate.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Muneer A, Laghari ZH, Shaikh AR, Laghari QA (2009) Gynecomastia: management in a developing country. J Ayub Med Coll Abbottabad 21(3):7–11
Cordova A, Moschella F (2008) Algorithm for clinical evaluation and surgical treatment of gynecomastia. J Plast Reconstr Aesthet Surg 61(1):41–9
Cuhaci N, Polat SB, Evranos B, Ersoy R, Cakir B (2014) Gynecomastia: clinical evaluation and management. Indian J Endocrinol Metab 18(2):150–8
Baumann K (2018) Gynecomastia—conservative and surgical management. Breast Care (Basel) 13(6):419–424
Longheu A, Medas F, Corrias F, Farris S, Tatti A, Pisano G, Erdas E, Calò PG (2016) Surgical management of gynecomastia: experience of a general surgery center. G Chir Jul-Aug 37(4):150–154
Simon BE, Hoffman S, Kahn S (1973) Classification and surgical correction of gynecomastia. Plast Reconstr Surg 51:48–56
Fruhstorfer BH, Malata CM (2003) A systematic approach to the surgical treatment of gynaecomastia. Br J Plast Surg 56(3):237–246
Brown RH, Chang DK, Siy R, Friedman J (2015) Trends in the surgical correction of gynecomastia. Semin Plast Surg 29(2):122–30
Holzmer SW, Lewis PG, Landau MJ, Hill ME (2020) Surgical management of gynecomastia: a comprehensive review of the literature. Plast Reconstr Surg Glob Open 8(10):e3161
Pitanguy I (1966) Transareolar incision for gynecomastia. Plast Reconstr Surg 38(5):414–419
Durani P, McCulley SJ (2007) Transareolar and H-incisions for the surgical treatment of gynecomastia. Plast Reconstr Surg 119(4):1387–1388
Atiyeh BS, Chahine F, El-Khatib A, Janom H, Papazian N (2015) Gynecomastia: simultaneous subcutaneous mastectomy and areolar reduction with minimal inconspicuous scarring. Aesthetic Plast Surg 39(6):916–21
Hammond DC, Arnold JF, Simon AM, Capraro PA (2003) Combined use of ultrasonic liposuction with the pull-through technique for the treatment of gynecomastia. Plast Reconstr Surg 112(3):891–5
Lista F, Ahmad J (2008) Power-assisted liposuction and the pull-through technique for the treatment of gynecomastia. Plast Reconstr Surg 121(3):740–7
Ramon Y, Fodor L, Peled IJ, Eldor L, Egozi D, Ullmann Y (2005) Multimodality gynecomastia repair by cross-chest power-assisted superficial liposuction combined with endoscopic-assisted pull-through excision. Ann Plast Surg 55(6):591–4
Bracaglia R, Fortunato R, Gentileschi S, Seccia A, Farallo E (2004) Our experience with the so-called pull-through technique combined with liposuction for management of gynecomastia. Ann Plast Surg 53(1):22–26
Morselli PG (1996) “Pull-through”: a new technique for breast reduction in gynecomastia. Plast Reconstr Surg 97(2):450–454
Varlet F, Raia-Barjat T, Bustangi N, Vermersch S, Scalabre A (2019) Treatment of gynecomastia by endoscopic subcutaneous mastectomy in adolescents. J Laparoendosc Adv Surg Tech A 29(8):1073–1076
Jian C, Limin Wu, Lin L, Liu W, Zheng Z, Yang C (2020) Single-port endoscopic mastectomy via the lateral chest approach for the treatment of grade II gynecomastia. Medicine (Baltimore) 99(22):e20100
Scuderi N, Tenna S, Spalvieri C, De Gado F (2005) Power-assisted lipoplasty versus traditional suction-assisted lipoplasty: comparative evaluation and analysis of output. Aesthetic Plast Surg Jan-Feb 29(1):49–52
Author information
Authors and Affiliations
Corresponding authors
Ethics declarations
Conflict of Interest
The authors declare no competing interests.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Romeo, F., Lago, G., Di Cesare, T. et al. Combined Traditional Lipoaspiration and Modified “Pull-Through” Technique for the Treatment of Gynecomastia: Our Experience. Indian J Surg 85, 420–426 (2023). https://doi.org/10.1007/s12262-022-03442-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12262-022-03442-z