From private practice.
Plast Reconstr Surg. 2021 May 1;147(5):1072-1083. doi: 10.1097/PRS.0000000000007901.
Male chest definition surgery and patients complaining of breast tissue overgrowth have been increasing in recent decades. After the authors' first report of pectoral etching in 2012, patients and surgeons became more aware about gynecomastia resection when performing pectoral enhancement. The authors present their experience with pectoral high-definition liposculpture in addition to inverted-omega incision resection for gynecomastia.
The authors reviewed their records on pectoral high-definition lipo sculpture between January of 2005 and October of 2019 in four surgical centers in Colombia. Inclusion criteria were as follows: men diagnosed with gynecomastia and body mass index less than or equal to 32 kg/m2, adequate skin elasticity, and general good health. Photographs were taken preoperatively and 1, 3, 6, and 12 months postoperatively. Follow-up ranged from 2 months to 3 years.
Gynecomastia resection plus high-definition liposculpture was successfully performed in 436 consecutive men (open inverted-omega incision resection, n = 132; liposuction, n = 304). Ages ranged from 18 to 66 years. Fat grafting volume ranged from 50 to 300 cc in each pectoral muscle. Minor complications (3.2 percent) included prolonged swelling, bruising, asymmetries, and residual gynecomastia. Major complications (1.6 percent) included unilateral hematoma and localized infection. No necrosis, systemic infection, or muscle paralysis was reported. A nonstandardized survey showed a very high satisfaction index.
Gynecomastia treatment combining high-definition liposculpture to male breast tissue resection through a new, almost invisible incision allowed us to achieve an athletic and natural appearance of the male pectoral area with a very low rate of complications.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
近几十年来，男性胸部塑形手术和抱怨乳房组织过度生长的患者数量不断增加。自作者 2012 年首次报告胸肌雕刻术以来，在进行胸肌增强时，患者和外科医生对乳腺切除术的认识更加深入。作者介绍了他们在哥伦比亚四个手术中心进行的胸肌高清脂肪雕刻术以及倒ω形切口切除治疗男性乳房发育症的经验。
作者回顾了 2005 年 1 月至 2019 年 10 月在哥伦比亚四个手术中心进行的胸肌高清脂肪雕刻术的记录。纳入标准如下：诊断为男性乳房发育症且体重指数（BMI）≤32kg/m2，皮肤弹性良好，整体健康状况良好的男性。术前、术后 1、3、6 和 12 个月拍摄照片。随访时间为 2 个月至 3 年。
连续 436 例男性患者（开放性倒ω形切口切除术，n=132；吸脂术，n=304）成功进行了乳腺切除术联合高清脂肪雕刻术。年龄在 18 岁至 66 岁之间。每个胸肌的脂肪移植量在 50 至 300cc 之间。轻微并发症（3.2%）包括肿胀、瘀伤、不对称和残留的男性乳房发育症。主要并发症（1.6%）包括单侧血肿和局部感染。未报告坏死、全身感染或肌肉瘫痪。一项非标准化调查显示，满意度指数非常高。
通过新的、几乎看不见的切口将高清脂肪雕刻术与男性乳房组织切除术相结合，治疗男性乳房发育症，使男性胸肌区域呈现出运动和自然的外观，并发症发生率非常低。
临床问题/证据水平：治疗性，IV 级。
