Sub-nipple Incision for Gland Resection in Gynecomastia, Combined with High-Definition Liposculpture Principles: Technical Refinements and a Step-by-Step Video Guide.

Gynecomastia correction often requires removal of both a glandular and fat component. Aggressive tissue removal bears the risk of causing irregularities, areolar scars, or a flat chest. Insufficient removal, on the other hand, causes recurrence. We present a new minimally invasive technique combining adequate gland removal with minimal scarring and improved contour. Our technique is based on the observation that we can make the retroareolar fibroglandular tissue extremely moldable if we first remove all the fat from between the periareolar fibrous strands. This fat removal requires a 3-mm or smaller power-assisted liposuction canula. Next, glandular resection is possible through a 7-mm incision at the base of the nipple. Combined with principles from high-definition liposculpture, superior esthetic results can be obtained.Level of Evidence V 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 .