Lista Frank, Ahmad Jamil
Mississauga, Ontario, Canada; and Dallas, Texas From the Plastic Surgery Clinic; Division of Plastic Surgery, Trillium Health Center; and Department of Plastic Surgery, University of Texas Southwestern Medical Center.
Plast Reconstr Surg. 2008 Mar;121(3):740-747. doi: 10.1097/01.prs.0000299907.04502.2f.
Gynecomastia is a common condition affecting many adolescent and adult males. Surgical techniques utilizing a variety of incisions, excisions, suction-assisted lipectomy, ultrasound-assisted liposuction, power-assisted liposuction, or some combination of these methods have been used in the treatment of gynecomastia. This article describes the authors' method of using power-assisted liposuction and the pull-through technique to treat gynecomastia.
This technique involves the use of power-assisted liposuction to remove fatty breast tissue. The pull-through technique is then performed utilizing several instruments to sever the subdermal attachments of fibroglandular breast tissue; this tissue is removed through the incision used for liposuction. Finally, power-assisted liposuction is performed again to contour the remaining breast tissue. A chart review of 99 consecutive patients (197 breasts) treated between January of 2003 and November of 2006 was performed.
Ninety-six patients (192 breasts) were successfully treated using this technique. Power-assisted liposuction was performed in all cases, and the average volume aspirated per breast was 459 ml (range, 25 to 1400 ml). Using the pull-through technique, the authors were able to remove between 5 and 70 g of tissue per breast. Complications were minimal (1.0 percent of breasts), and no revisions were required.
Since January of 2003, the authors have used this technique to successfully treat 97 percent of their gynecomastia patients. Combining power-assisted liposuction and the pull-through technique has proven to be a versatile approach for the treatment of gynecomastia and consistently produces a naturally contoured male breast while resulting in a single inconspicuous scar.
男性乳房肥大是一种常见病症，影响着许多青少年和成年男性。利用各种切口、切除术、吸脂辅助抽脂术、超声辅助吸脂术、动力辅助吸脂术或这些方法的某种组合的手术技术已被用于治疗男性乳房肥大。本文描述了作者使用动力辅助吸脂术和贯穿技术治疗男性乳房肥大的方法。
该技术包括使用动力辅助吸脂术去除乳腺脂肪组织。然后使用多种器械实施贯穿技术，切断纤维腺性乳腺组织的皮下附着；该组织通过用于吸脂的切口移除。最后，再次进行动力辅助吸脂术以塑形剩余的乳腺组织。对2003年1月至2006年11月期间连续治疗的99例患者（197侧乳房）进行了图表回顾。
96例患者（192侧乳房）使用该技术成功治疗。所有病例均进行了动力辅助吸脂术，每侧乳房平均吸出量为459毫升（范围为25至1400毫升）。使用贯穿技术，作者能够每侧乳房去除5至70克组织。并发症极少（占乳房的1.0%），无需进行修复手术。
自2003年1月以来，作者使用该技术成功治疗了97%的男性乳房肥大患者。事实证明，将动力辅助吸脂术和贯穿技术相结合是一种治疗男性乳房肥大的通用方法，始终能塑造出自然塑形的男性乳房，同时只留下一条不显眼的疤痕。
