Ali Sheikh Sarfraz, Ahmed Imran, Khurram Mohammed Fahud, Rehman Noha, Abhishek Rupraj
Department of Plastic Surgery, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
Indian J Plast Surg. 2025 Jan 23;58(4):269-275. doi: 10.1055/s-0045-1802327. eCollection 2025 Aug.
Gynecomastia, affecting around 30% of young males, has seen evolving surgical treatments, transitioning from traditional excision methods to contemporary techniques like liposuction. Emotional distress persists when glandular tissue is inadequately addressed, prompting exploration of combined liposuction and glandular excision procedures.
Patients undergoing gynecomastia surgery over a period of 2 years were assessed, considering their demographics, medical history, and gynecomastia grade. Surgical procedures involved liposuction alone or with glandular excision. Endoscopy was used to assess the presence of fibroglandular tissue and the need for glandular excision. Postoperative assessments, clinical photography, and patient questionnaires spanned a 6-month follow-up.
Thirty-two breasts (17 in liposuction alone and 15 in liposuction with glandular excision groups) were included. Liposuction alone led to bruising and two hematomas, and "puffy nipples" necessitating one redo surgery. Glandular excision resulted in four cases of crater deformity and one case each of superficial skin necrosis, hematoma, and seroma. Cosmetic evaluations showed similar outcomes, with the liposuction alone group having higher redo surgery rates.
This study finds that combining liposuction with glandular excision delivers comparable cosmetic results to liposuction alone for gynecomastia. Despite added complexity, the combined approach proves effective and helps in decision-making, emphasizing the need for tailored techniques and ongoing research to optimize treatment strategies.
男性乳房肥大影响着约30%的年轻男性，其手术治疗方法不断演变，从传统的切除方法过渡到了如抽脂等现代技术。当腺体组织处理不充分时，情感困扰依然存在，这促使人们探索抽脂与腺体切除相结合的手术方法。
对两年内接受男性乳房肥大手术的患者进行评估，考虑其人口统计学特征、病史和男性乳房肥大分级。手术方法包括单纯抽脂或抽脂加腺体切除。采用内窥镜检查来评估纤维腺体组织的存在情况以及是否需要进行腺体切除。术后评估、临床摄影和患者问卷调查涵盖了6个月的随访期。
共纳入32个乳房（单纯抽脂组17个，抽脂加腺体切除组15个）。单纯抽脂导致了瘀斑和两例血肿，以及“乳头肿胀”，其中一例需要再次手术。腺体切除导致4例坑状畸形，以及各1例浅表皮肤坏死、血肿和血清肿。美容评估显示结果相似，单纯抽脂组的再次手术率较高。
本研究发现，对于男性乳房肥大，抽脂与腺体切除相结合的方法与单纯抽脂的美容效果相当。尽管增加了手术复杂性，但联合方法被证明是有效的，有助于决策，强调需要采用定制技术并持续开展研究以优化治疗策略。
