University of Pittsburgh Medical School, 3109 Forbes Avenue, Suite 500, Pittsburgh, PA 15213, USA.
Hurwitz Center for Plastic Surgery; UNLV School of Medicine, 1701 W Charleston Blvd, Las Vegas, NV 89102, USA.
Clin Plast Surg. 2022 Apr;49(2):293-305. doi: 10.1016/j.cps.2021.12.003.
Contemporary management of gynecomastia includes transareolar excision of gland, disruption of inframammary fold, ultrasonic-assisted lipoplasty with muscular definition, bipolar radiofrequency tightening, pedicled NAC mastopexy with boomerang pattern excision and J torsoplasty, NAC grafts with hockey stick excision pattern, and pectoralis muscle lipoaugmentation. Therapeutic options are arranged across a modified Simon classification. The aesthetic goal is near total glandular reduction, with proper position and shape of the nipple areolar complexes, and masculinity with skin adherence reflecting musculoskeleton. Clinical cases demonstrate these multiple approaches, successes, and pitfalls. Complications relate to delayed healing caused by excessive closure tension or inadequate or inappropriate treatment.
目前，男性乳房发育症的治疗方法包括乳晕切口乳腺组织切除术、乳晕下皱襞打断、超声辅助吸脂并保留肌性结构、双极射频收紧、带蒂乳头乳晕复合体上蒂皮瓣乳房下垂矫正术、Boomerang 形乳晕区腺体切除术联合 J 形成形术、乳头乳晕复合体缩小成形术、胸大肌脂肪填充。治疗方法按照 Simon 改良分类排列。美学目标是尽量减少腺体组织，乳头乳晕复合体位置和形态适当，皮肤贴合度反映肌骨结构，具有男性特征。临床病例展示了这些多种方法的成功和不足。并发症与切口张力过大或治疗不足或不当导致的延迟愈合有关。
