Abstract
Background
Several different methods have been proposed for treatment of gynecomastia, depending on the amount of breast enlargement and skin redundancy. The liposuction pull-through technique has been proposed as an efficacious treatment for many gynecomastia cases. This work aims to study the outcome of this technique when applied as an outpatient procedure, without the use of drains and through a single incision.
Methods
Fifty-two patients with bilateral gynecomastia without significant skin excess were included in this study. The liposuction pull-through technique was performed through a single incision just above the inframammary fold and without the use of drains. Patients were followed up for 6 months.
Results
The proposed technique was able to treat the gynecomastia in all patients, with a revision rate of 1.9% to remove residual glandular tissues. There were no seromas, hematomas, nipple distortion, permanent affection of nipple sensation or wound healing problems.
Conclusion
The liposuction pull-through technique is an effective treatment for gynecomastia without significant skin redundancy. It combines the benefits of the direct excision of glandular tissues, with the minimally invasive nature of liposuction. Performing the procedure through a single incision without the use of drains and without general anesthesia is a safe alternative.
Level of evidence IV
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References
Li CC, Fu JP, Chang SC, Chen TM, Chen SG (2012) Surgical treatment of gynecomastia: complications and outcomes. Ann Plast Surg 69(5):510–515
Simon B, Hoffman S, Kahn S (1973) Classification and surgical correction of gynecomastia. Plast Reconstr Surg 51(1):48–52
Morselli PG (1996) “Pull-through”: a new technique for breast reduction in gynecomastia. Plast Reconstr Surg 97(2):450–454
Mladick RA (1991) Gynecomastia: liposuction and excision. Clin Plast Surg 18:815
Rohrich RJ, Ha RY, Kenkel JM, Adams WP (2003) Classification and management of gynecomastia: defining the role of ultrasound-assisted liposuction. Plast Reconstr Surg 111(2):909–923
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
Lista F, Ahmad J (2008) Power-assisted liposuction and the pull-through technique for the treatment of gynecomastia. Plast Reconstr Surg 121(3):740–747
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):591–594
Moreslli P, Morellini A (2012) Breast reshaping in gynecomastia by the “pull-through technique”: considerations after 15 years. Ear J Plats Surg 35(5):365–371
Kumar S, Lal B, Misra MC (1995) Post-mastectomy seroma: a new look into the aetiology of an old problem. J R Coll Surg Edinb 40(5):292–294
Saratzis A, Soumian S, Willetts R, Rastall S, Stonelake PS (2009) Use of multiple drains after mastectomy is associated with more patient discomfort and longer postoperative stay. Clin Breast Cancer 9(4):243–246
Jain PK, Sowdi R, Anderson AD, MacFie J (2004) Randomized clinical trial investigating the use of drains and fibrin sealant following surgery for breast cancer. Br J Surg 91(1):54–60
Babigian A, Silverman RT (2001) Management of gynecomastia due to use of anabolic steroids in bodybuilders. Plast Reconstr Surg 107:240–242
Ratnam BV (2009) A new classification and treatment protocol for gynecomastia. Aesthet Surg J 29:26–31
Cigna E, Tarallo M, Fino P et al (2011) Surgical correction of gynecomastia in thin patients. Aesthetic Plast Surg 35:439–445
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):891–895 discussion 896-7
Pusic AL, Klassen AF, Scott AM, Klok JA, Cordeiro PG, Cano SJ (2009) Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q. Plast Reconstr Surg 124(2):345–353
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Khalil, A.A., Ibrahim, A. & Afifi, A.M. No-Drain Single Incision Liposuction Pull-Through Technique for Gynecomastia. Aesth Plast Surg 41, 298–303 (2017). https://doi.org/10.1007/s00266-016-0749-z
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DOI: https://doi.org/10.1007/s00266-016-0749-z