External Quilting: New Technique to Avoid Haematoma in Gynaecomastia Surgery
Haematoma after gynaecomastia surgery is the most common early complication. It may necessitate a return to the theatre and cause increased infection risk, poor wound or delayed healing, and abnormal scar. Strategies to avoid haematoma range from perioperative blood pressure control to the use of tranexamic acid and compressive dressings.
To demonstrate a new technique that would avoid haematoma or limit its expansion should it occur, after gynaecomastia surgery.
One hundred and forty-nine patients had surgery for gynaecomastia between 2018 and 2019 by the senior author. External quilting sutures are used to obliterate any dead space following liposuction and piecemeal excision to address fatty, stromal, and glandular components. No drains are used. Patients receive cooling therapy before discharge, and they reattend clinic the following day for suture removal.
Two patients had haematomas which were managed conservatively and healed well. Fine suture tracks, which were observed in another two patients, became unnoticeable at 3 months. Overall, the complication rate in our cohort was 2.7% (haematoma 1.3%, temporary suture track 1.3%).
Our method is useful in minimising haematoma. It limits expansion of haematoma should it occur. Suture track is the other transient complication. This new technique in gynaecomastia correction is simple, yields good results, and gives the surgeon another option to deal with haematoma.
Level of Evidence IV
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KeywordsGynaecomastia External quilting Haematoma
The authors received no financial or material support.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all patients.
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