Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Via Manzoni 56, 20089, Rozzano, MI, Italy.
Plastic Surgery Unit, MultiMedica Holding S.p.A., Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Via Milanese 300, 20089, Sesto San Giovanni, MI, Italy.
Aesthetic Plast Surg. 2021 Aug;45(4):1397-1403. doi: 10.1007/s00266-021-02187-6. Epub 2021 Feb 24.
Gynecomastia is the most common form of breast alteration in men, due to proliferation of the gland ducts and stromal components, including fat. In addition to the most obvious indications (weight loss, pharmacotherapy, and drugs suspension), the surgical treatment is needed for long-standing gynecomastia, combining liposuction, adenectomy, partial mammary adenectomy, periareolar skin resection, and round-block suture.
A retrospective study was conducted on 148 patients undergoing gynecomastia correction from May 2012 to April 2018. Follow-up ranged from 9 to 14 months. The authors propose a new ultrasound-confirmed classification system, dividing patients into six categories. The authors analyzed immediate complications, revision, recurrence, and minor aesthetic problems (retracted/depressed areas) and introduced a way to correct the irregularities with fat grafting and needles.
The total complication rate was 11.5% (17/148). Most of the complications (11) were observed in patients who underwent glandular resection and 3 after liposuction only. Retrospective surveys about patients' and surgeons' satisfaction were performed, showing excellent feedbacks regarding the results accomplished.
The simple classification helps surgeons choose the most suitable approach, avoiding insufficient or invasive treatments and undesirable scars. Moreover, the analysis of the type of sequelae and their correction allow high patients' satisfaction.
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 .
男性乳房发育症是最常见的乳房改变形式，由于乳腺导管和基质成分（包括脂肪）的增殖。除了最明显的指征（减肥、药物治疗和药物停用）外，对于长期存在的男性乳房发育症，需要手术治疗，结合吸脂术、腺切除术、部分乳腺腺切除术、乳晕周围皮肤切除术和圆形块缝线。
对 2012 年 5 月至 2018 年 4 月期间接受乳房矫正的 148 例男性乳房发育症患者进行了回顾性研究。随访时间为 9 至 14 个月。作者提出了一种新的超声证实的分类系统，将患者分为六类。作者分析了即刻并发症、修复、复发和轻微美容问题（凹陷/凹陷区域），并介绍了一种用脂肪移植和针来纠正不规则的方法。
总并发症发生率为 11.5%（17/148）。大多数并发症（11 例）发生在接受腺体切除术的患者中，3 例发生在仅吸脂术的患者中。对患者和外科医生的满意度进行了回顾性调查，结果显示对所取得的结果非常满意。
简单的分类有助于外科医生选择最合适的方法，避免不充分或侵入性的治疗和不理想的疤痕。此外，对后遗症类型的分析及其纠正可以提高患者的满意度。
证据水平 IV：本杂志要求作者为每篇文章分配一个证据水平。有关这些循证医学评级的完整描述，请参考目录或在线作者指南 www.springer.com/00266。
