3D Mammometric Changes in the Treatment of Idiopathic Gynecomastia
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Three-dimensional surface imaging (3DSI) has shown promise for plastic surgeons to objectively assess changes in body contour and breast volume.
To assess the surgical outcome after bilateral subcutaneous mastectomy (BSM) and water jet-assisted liposuction (WAL) as treatment for idiopathic gynecomastia, using 3DSI to document changes regarding nipple–areolar complex (NAC) and breast volume.
Thirty male patients (Simon II A to B) receiving BSM and WAL were enrolled. Eight subjects received additional mastopexy and NAC reduction. Use of a Vectra 3D Imaging System® before and 6 months after surgery provided data regarding changes of NAC placement and NAC and breast dimensions. The sum volume of intraoperatively approximated lipoaspirate before and after centrifugation and mastectomy specimens quantified using water displacement were compared with 3D-assessed differences in volume.
When compared to the NAC dimensions defined during surgery, patients receiving NAC reductions showed nonsignificant postoperative changes in NAC dimensions. Patients without additional mastopexy showed a significant (p < 0.001) vertical (15.7 ± 14.3%) and horizontal (17.1 ± 15.0%) reduction in NAC diameter. 3D volume changes (92.8 ± 26.4 mL) showed significant differences (p < 0.001) 6 months after surgery compared to the intraoperatively measured lipoaspirate before (182 ± 54.5 mL) and after (120 ± 34.6 mL) centrifugation.
Although it is clear that patient satisfaction must remain the prime focus of surgical body contouring, 3DSI has proven valuable to objectively demonstrate both the anticipated outcome and further findings regarding treatment of idiopathic gynecomastia.
Level of Evidence IV
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KeywordsGynecomastia 3D surface imaging Liposuction Volumetry Nipple–areolar complex
Compliance with Ethical Standards
Conflict of interest
The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article. None of the figures or tables have been previously published, and the copyright is held by the authors.
All procedures in our study involving human participants were conducted in accordance with the standards of the Ludwig-Maximilians-University Munich ethical committee (Reference Number 266-13) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
All participants signed an informed consent approved by the institutional ethics committee.
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