Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Division of Plastic Surgery, Department of Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
J Plast Reconstr Aesthet Surg. 2024 Dec;99:175-184. doi: 10.1016/j.bjps.2024.09.040. Epub 2024 Sep 17.
Mixed-type gynecomastia is a benign male breast condition characterized by the proliferation of glandular and adipose tissues. Conventional open surgery has been the main approach for treating gynecomastia. However, this method has been associated with complications, including breast deformity, noticeable scar, nipple necrosis, and hypoesthesia. In contrast, vacuum-assisted biopsy systems and liposuction have demonstrated significant advantages in minimally invasive breast surgery.
Our study aimed to investigate the effectiveness of combining vacuum-assisted mastectomy with power-assisted liposuction (VAM+PAL) for patients with mixed-type gynecomastia compared to conventional open surgery.
Sixty patients with mixed-type gynecomastia, treated between January 2019 and June 2023, were included in this study. VAM+PAL was performed on 30 patients (59 breasts), and open excision with periareolar approach was performed on 30 patients (59 breasts). The efficacy, complications, outcomes, scar cosmesis, and patient satisfaction were assessed.
Compared to open excision group for gynecomastia, the VAM+PAL group demonstrated a substantial reduction in incision size (4.47 ± 1.21 cm vs. 0.97 ± 0.74 cm, p < 0.001) and lower scores of Vancouver scar scale (3.23 ± 2.27 vs. 1.10 ± 1.47, p < 0.001). No drainage tubes were required for postoperative hematoma/seroma prevention. The patients in the VAM+PAL group had significantly lower complication rates (18.64% vs. 3.39%, p = 0.008), particularly in bruise and hypoesthesia. All VAM+PAL patients reported superior satisfaction with the outcomes in breasts and nipples.
The combination of vacuum-assisted mastectomy and power-assisted liposuction can be used as an efficient minimally invasive method to treat mixed-type gynecomastia with acceptable complications, superior scar cosmesis, and satisfying outcomes.
混合型男性乳房发育症是一种良性男性乳房疾病，其特征是腺体和脂肪组织增生。传统的开放性手术一直是治疗男性乳房发育症的主要方法。然而，这种方法与并发症有关，包括乳房畸形、明显的疤痕、乳头坏死和感觉减退。相比之下，真空辅助活检系统和吸脂术在微创乳房手术中具有显著优势。
我们的研究旨在比较真空辅助乳房切除术联合动力辅助吸脂术（VAM+PAL）与传统开放性手术治疗混合型男性乳房发育症的效果。
本研究纳入了 2019 年 1 月至 2023 年 6 月期间接受治疗的 60 例混合型男性乳房发育症患者。其中 30 例（59 侧乳房）患者接受 VAM+PAL 治疗，30 例（59 侧乳房）患者接受乳晕周围切口的开放性切除术。评估疗效、并发症、结果、疤痕美容效果和患者满意度。
与开放性切除组相比，VAM+PAL 组的切口尺寸显著减小（4.47 ± 1.21 cm 比 0.97 ± 0.74 cm，p < 0.001），温哥华疤痕量表评分较低（3.23 ± 2.27 比 1.10 ± 1.47，p < 0.001）。无需引流管预防术后血肿/血清肿。VAM+PAL 组的并发症发生率显著较低（18.64%比 3.39%，p = 0.008），特别是瘀伤和感觉减退。所有 VAM+PAL 患者均对乳房和乳头的结果表示满意。
真空辅助乳房切除术联合动力辅助吸脂术可作为一种有效的微创方法，用于治疗混合型男性乳房发育症，其并发症可接受，疤痕美容效果好，结果满意。
