Plastic, Reconstructive and Aesthetic Surgery Clinic, Istanbul Aydin University Medical Park Hospital, Istanbul, Turkey.
Plastic, Reconstructive and Aesthetic Surgery Clinic, Istanbul Teaching and Research Hospital, Istanbul, Turkey.
Aesthetic Plast Surg. 2020 Apr;44(2):435-441. doi: 10.1007/s00266-019-01477-4. Epub 2019 Aug 26.
Whereas body-contouring surgery after massive weight loss in women receives much attention, little attention has been devoted to accentuating the male physique. Male patients after massive weight loss often suffer from redundant skin and soft tissue in the anterior and lateral chest region, causing various deformities of pseudogynecomastia. The authors present their approach to high-grade pseudogynecomastia correction with preservation of the NAC on an inferior dermoglandular pedicle with transverse scar only closure and without any meaningful liposuction.
A description of comprehensive pseudogynecomastia correction with the aforementioned technique followed by review of 58 consecutive patients operated on in our clinic from January 2017 to June 2018. Epidemiological data such as age, weight, height, body mass index (BMI), weight loss, and the medical history of each patient were collected. All patients were photo-documented preoperatively and postoperatively in a standard manner. During the operation, weight of resected tissue and operative time were noted.
Fifty-eight patients were operated on in a single stage. In our series, one patient had unilateral partial necrosis on nipple-areola complex, and two patients had minimal to moderate amounts of hematoma which were followed up without intervention. We did not encounter any infection-related complications or skin redundancy in our patients. Out of 58 patients, 55 of all the patients were highly satisfied with the aesthetic results. Three patients were mildly satisfied with the results, but they stress that moderate scar widening was the reason for the displeasure, not the definition of the chest which was deemed as satisfactory like the rest.
Our technique obviates the need for skin resection in a second operation, allows immediate skin recontouring, and provides a viable nipple-areola complex at the desired location. The patient does not have to suffer prolonged stress while awaiting skin retraction and is protected from a second dose of anesthesia and hospitalization.
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尽管女性大量减肥后的身体塑形手术备受关注，但对于突出男性体格的关注却很少。大量减肥后的男性患者常在前侧和外侧胸部区域出现多余的皮肤和软组织，导致各种假性女性乳房畸形。作者介绍了一种仅通过横向瘢痕闭合，不进行任何有意义的抽脂，保留乳头乳晕复合体（NAC），使用下真皮腺体蒂纠正高级别假性女性乳房畸形的方法。
详细描述了使用上述技术全面纠正假性女性乳房畸形，并对 2017 年 1 月至 2018 年 6 月在我们诊所接受手术的 58 例连续患者进行了回顾。收集了每位患者的年龄、体重、身高、体重指数（BMI）、减肥情况和病史等流行病学数据。所有患者均以标准方式进行术前和术后拍照记录。手术过程中，记录切除组织的重量和手术时间。
58 例患者在一个阶段完成了手术。在我们的系列中，有 1 例患者的乳头乳晕复合体出现单侧部分坏死，有 2 例患者出现少量至中度血肿，无需干预即可随诊。我们的患者没有出现任何与感染相关的并发症或皮肤冗余。在 58 例患者中，55 例患者对美学结果非常满意。有 3 例患者对结果轻度满意，但他们强调中度瘢痕增宽是不满意的原因，而不是胸部的定义，他们认为胸部与其他人一样满意。
我们的技术避免了在第二次手术中进行皮肤切除的需要，允许立即进行皮肤重塑，并在所需位置提供可行的乳头乳晕复合体。患者不必长时间承受皮肤回缩的压力，并免受第二次麻醉和住院的影响。
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