Lee Sung Ryul, Lee Seung Geun, Byun Geon Young, Kim Myoung Jin, Koo Bum Hwan
Department of Surgery, Damsoyu Hospital, Central Tower 5-9F, Bongeunsa-ro 213, Gangnam-gu, Seoul, Republic of Korea.
Aesthetic Plast Surg. 2018 Jun;42(3):708-715. doi: 10.1007/s00266-018-1102-5. Epub 2018 Feb 20.
Asymmetric bilateral gynecomastia (ABGM) is uncommon, and reports on its characteristics are rare. In the present study, we investigated the clinical characteristics and surgical treatment of ABGM.
We conducted a retrospective study of 1159 patients with gynecomastia who underwent subcutaneous mastectomy with liposuction at Damsoyu Hospital from January 2014 to February 2016. We then analyzed differences in the characteristics and operative results between two groups of patients: those with asymmetric and symmetric gynecomastia. Asymmetric gynecomastia was defined as gynecomastia meeting both of the following criteria: (1) upon physical examination, the size of the palpable mass below the nipple-areolar complex was twice as large as the smaller one, and (2) upon ultrasonography, the depth of the glandular tissue under the nipple-areolar complex was twice as large as the smaller one.
Fifty-four patients were diagnosed with asymmetric gynecomastia. Among them, 51 had ABGM and three had unilateral gynecomastia. In the asymmetric group, more patients had a larger left than right breast (33 patients, 64.7%). The incidence of true-type (entirely glandular) breasts was significantly higher in the asymmetric group (84.3%) than in the symmetric group (p < 0.001). The asymmetry ratios in the asymmetric and symmetric groups were 1.87 ± 2.07 and 0.20 ± 0.16, respectively (p < 0.001).
Bilateral mastectomy provided an acceptable and symmetric cosmetic outcome in patients with ABGM.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
不对称双侧男性乳房肥大（ABGM）并不常见，关于其特征的报道很少。在本研究中，我们调查了ABGM的临床特征及手术治疗方法。
我们对2014年1月至2016年2月在Damsoyu医院接受皮下乳房切除术联合抽脂术的1159例男性乳房肥大患者进行了回顾性研究。然后分析了两组患者（不对称性和对称性男性乳房肥大患者）的特征及手术结果差异。不对称性男性乳房肥大定义为符合以下两项标准的男性乳房肥大：（1）体格检查时，乳头乳晕复合体下方可触及肿块的大小是较小肿块的两倍；（2）超声检查时，乳头乳晕复合体下方腺体组织的深度是较浅侧的两倍。
54例患者被诊断为不对称性男性乳房肥大。其中，51例为ABGM，3例为单侧男性乳房肥大。在不对称组中，左乳房大于右乳房的患者更多（33例，64.7%）。不对称组真性（完全为腺体组织）乳房的发生率显著高于对称组（84.3%，p<0.001）。不对称组和对称组的不对称率分别为1.87±2.07和0.20±0.16（p<0.001）。
双侧乳房切除术为ABGM患者提供了可接受的对称美容效果。
证据等级IV：本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述，请参阅目录或作者在线指南www.springer.com/00266 。
