Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany.
Department of Plastic, Reconstructive and Aesthetic Surgery, ISAR Klinikum, Munich, Germany.
Aesthetic Plast Surg. 2021 Apr;45(2):431-437. doi: 10.1007/s00266-020-02029-x. Epub 2020 Oct 27.
The enlarged nipple-areola-complex (NAC) is a characterizing aspect of gynecomastia.
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).
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.
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 1.60cm (SD 1.48) or 23.37% (SD 9.78) after 5.82 years and in the SCM+UAL cohort 2.60cm (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.
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.
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增大的乳头乳晕复合体（NAC）是男性乳房发育症的一个特征。
本研究的目的是多维量化皮下乳房切除术（SCM）后 NAC 的缩小，包括或不包括超声辅助吸脂术（UAL）。
对 11 年来因男性乳房发育症接受 SCM +/- UAL 的患者进行回顾性评估。在手术前后测量 NAC 直径。此外，还进行了一项针对患者为中心的结果的调查（包括 BREAST-Q）。
研究队列由 55 名男性组成，共 105 个 NAC（SCM n=63，SCM+UAL n=42）。结果表明，考虑到所有参数（水平和垂直直径和面积），UAL 联合 SCM 的 NAC 缩小明显大于仅 SCM 组（p<0.001）。SCM 组的平均面积减少为 1.60cm（SD 1.48）或 23.37%（SD 9.78），随访时间为 5.82 年；而 SCM+UAL 组为 2.60cm（SD 1.60）或 35.85%（SD 6，86），随访时间为 7.43 年。作为 NAC 缩小的独立显著因素，确定了切除重量和 SCM+UAL 联合。两个队列之间的患者满意度（用 BODY-Q 测量）（p=0.222）和 ordinal 量表（p=0.445）无显著差异。
UAL 联合 SCM 在时间上较 SCM 独立于男性乳房发育症的阶段，对 NAC 的缩小效果更大。在计划男性乳房发育症的手术治疗时，必须考虑到技术和切除重量相关的 NAC 随时间的缩小。
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