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Expected Reduction of The Nipple-Areolar Complex Over Time After Treatment of Gynecomastia with Ultrasound-Assisted Liposuction Mastectomy Compared to Subcutaneous Mastectomy Alone

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  • Breast Surgery
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Abstract

Background

The enlarged nipple-areola-complex (NAC) is a characterizing aspect of gynecomastia.

Objective

The purpose of this study was to multidimensionally quantify the reduction of the NAC after a subcutaneous mastectomy (SCM) with or without ultrasound-assisted liposuction (UAL).

Materials and Methods

A retrospective assessment of patients who underwent SCM +/- UAL due to gynecomastia over a period of 11 years was conducted. The NAC diameters were measured before and after surgery. In addition, a survey (including the BREAST-Q) regarding patient-oriented outcome was performed.

Results

The study cohort consisted of 55 men and resulting 105 NACs (SCM n=63, SCM+UAL n=42). It could be shown that the reduction of the NAC considering all parameters (horizontal and vertical diameter and the area) was significantly larger (p=<0.001) in the SCM+UAL compared to the SCM only cohort. The mean reduction of the area in the SCM cohort was 1.60cm2 (SD 1.48) or 23.37% (SD 9.78) after 5.82 years and in the SCM+UAL cohort 2.60cm2 (SD 1.60) or 35.85% (SD 6,86) after 7.43 years. As independent significant factors for reduction of the NAC, the resection weight and SCM+UAL combination were identified. There were no significant differences regarding the patients’ satisfaction measured with the BODY-Q (p=0.222) and the ordinal scale (p=0.445) between the two cohorts.

Conclusions

The SCM with UAL showed a larger reduction over time of the NAC compared to the SCM independent from the stage of gynecomastia. When planning the surgical treatment of gynecomastia, a technique and resection weight dependent reduction of the NAC over time must be considered.

Level of Evidence IV

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Authors and Affiliations

  1. Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany

    Peter P. Pfeiler, Khaled Dastagir, Peter M. Vogt, Tobias R. Mett, Alexander Kaltenborn & Sören Könneker

  2. Department of Plastic, Reconstructive and Aesthetic Surgery, ISAR Klinikum, Munich, Germany

    Peter P. Pfeiler

  3. Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Trauma Center Eberhard Karl University Tübingen, Tübingen, Germany

    Rosalia Luketina

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  1. Peter P. Pfeiler
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  2. Rosalia Luketina
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Correspondence to Peter P. Pfeiler.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

The study was reviewed and approved of of ethical and legal aspects of research involving human subjects by the by the Institutional Review Board of Hannover Medical School (8003__BO_K_2019) and is registered in the German Clinical Trials Registry (DRKS00015234).

Informed Consent

All patients gave their informed consent prior to their inclusion in the study.

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Peter P. Pfeiler and Rosalia Luketina: Shared first authorship.

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Pfeiler, P.P., Luketina, R., Dastagir, K. et al. Expected Reduction of The Nipple-Areolar Complex Over Time After Treatment of Gynecomastia with Ultrasound-Assisted Liposuction Mastectomy Compared to Subcutaneous Mastectomy Alone. Aesth Plast Surg 45, 431–437 (2021). https://doi.org/10.1007/s00266-020-02029-x

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