Ngô B, Barry L, Bonte A, Belkhou A, Calibre C, Pasquesoone L, Guerreschi P, Duquennoy-Martinot V
Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHU de Lille, rue Émile Laine, 59037 Lille Cedex, France.
Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHU de Lille, rue Émile Laine, 59037 Lille Cedex, France.
Ann Chir Plast Esthet. 2022 Nov;67(5-6):382-392. doi: 10.1016/j.anplas.2022.07.023. Epub 2022 Sep 1.
Gynecomastia is the most frequently breast lesion in males. 148 patients (mean age 24,7 years) operated in our department were reviewed with a mean follow-up of five years. Gynecomastia occurred most frequently during puberty (77,7 %), was bilateral (86,5%) and idiopathic (89,9%). The size of the enlargement was evaluated according to Simon's-classification based on breast-volume and skin-redundancy. 17 (11,5%) stage 1, 77 (52%) stage 2A, 32 (21,6%) stage 2B, 22 (14,9%) stage 3. Clinical examination and mammography determined the consistency of gynecomastia: adipose or firm. 4 different surgical managements were used: 17 (11,5%) subcutaneous mastectomies, 4 (2,7%) liposuctions, 110 (74,3%) liposuctions associated with subcutaneous mastectomy, 17 (11,5%) total mastectomy. All techniques gave good morphologic results. Nonetheless, the authors recommend the combination «liposuction and subcutaneous mastectomy», as this technique presents many advantages: small intraoperative blood loss, good skin redraping, short hospital stay, complete histologic examination of the material removed.
男性乳房肥大是男性最常见的乳腺病变。对在我科接受手术的148例患者（平均年龄24.7岁）进行了回顾性研究，平均随访时间为5年。男性乳房肥大最常发生在青春期（77.7%），多为双侧（86.5%）且病因不明（89.9%）。根据基于乳房体积和皮肤冗余度的西蒙分类法评估乳房增大的程度。17例（11.5%）为1期，77例（52%）为2A期，32例（21.6%）为2B期，22例（14.9%）为3期。通过临床检查和乳腺X线摄影确定男性乳房肥大的质地：脂肪性或实性。采用了4种不同的手术治疗方法：17例（11.5%）行皮下乳房切除术，4例（2.7%）行抽脂术，110例（74.3%）行抽脂术联合皮下乳房切除术，17例（11.5%）行全乳房切除术。所有技术均取得了良好的形态学效果。尽管如此，作者推荐“抽脂术联合皮下乳房切除术”，因为该技术具有许多优点：术中出血量少、皮肤重新塑形良好、住院时间短、切除组织可进行完整的组织学检查。
