Home » Blog » GYNECOMASTIA: BREAST TISSUE REMOVAL THROUGH A SINGLE PUNCTURE INCISIONDr. Henry Mentz, Dr. Amado Ruiz, Dr. German Newall, Dr. Christopher Patronella

GYNECOMASTIA: BREAST TISSUE REMOVAL THROUGH A SINGLE PUNCTURE INCISIONDr. Henry Mentz, Dr. Amado Ruiz, Dr. German Newall, Dr. Christopher Patronella

OBJECTIVES: To present the clinical experience of 12 patients with gynecomastia in which the breast tissue was removed through a single 3mm puncture incision. To describe a simple, safe and reliable technique for the removal of the dense, fibrous male breast tissue that can offer predictable results and a minimal external scar.

MATERIALS AND METHODS: Twelve patients were operated between March 2000 and December of 2003. They were all performed by the lead author and part of the private practice of the Aesthetic Center for Plastic Surgery in Houston, TX. The procedure is carried out under general anesthesia. A small, axillary puncture is performed for tumescent infiltration and suctioning. Then, a 3mm periareolar incision is made at 6 o’clock of the respective side to be treated (Pictures 1 and 2). Although ultrasound-assisted liposuction has emerged as a safe and effective method for the removal of breast tissue in males, the authors preferred the standard method provided by conventional suctionassisted devices. Lipoaspiration in the breast area is performed in a standard fashion, with a radial direction from the periareolar puncture incision and axillary incision (Pictures 3 and 4). Through the periareolar incision, thin, blunt-tipped scissors are introduced, grasping subareolar tissue as demonstrated in Picture 5. Areola is undermined and ducts are transected (Picture 6). Strips of glandular tissue are created and removed through this same opening using hemostat and scissors (Picture 7). Glandular tissue is removed and careful undermining is conducted to correct any irregularities (Picture 8). Glandular strips are excised in a “piece meal” fashion, as seen on Picture 9. One 4-0 catgut suture is placed to close the skin (Picture 10). Paper tape or steri strips are use to reinforce skin closure. No drains are left. The patient wears a compression vest for 7 days.

RESULTS: > All 12 patients obtained excellent results with no complications in a 36 month follow-up period. > By utilizing piece-meal removal of the residual breast gland, the resulting scar is smaller and less conspicuous without compromising the final contour. > All 12 patients treated with this technique demonstrated a smooth, masculine breast contour with a wellconcealed scar. > The technique is fast, easy, straightforward and provides excellent consistent results.

CONCLUSION: We are optimistic with our results and believe this method of breast tissue removal by means of a single puncture incision could be the treatment of choice to correct this abnormality. The authors have found this technique to be effective in treating most grades of gynecomastia. The procedure is technically straightforward and provides consistent results.

REFERENCES: 1. Abramo, A.C.: “Axillary Approach for Gynecomastia Liposuction” Aesthetic Plast. Surg. 18:265, 1994 2. Ohyama,T., Takada, A., Fujikawa, M., and Hosokawa,K.: “Endoscope-Assisted Transaxillary Removal of Glandular Tissue in Gynecomastia” Ann. Plast. Surg. 40:62, 1998 3. Gingrass, M.K., and Shermak, M.A.: “The Treatment of Gynecomastia with Ultrasound-Assisted Lipoplasty” Perspect. Plast. Surg. 12:101, 1999 4. Rosenberg, G.J.: “Gynecomastia: Suction Lipectomy as a Contemporary Solution” Plast. Reconstr. Surg. 80:379, 1987

For additional information on this Medical Research article, please contact:

ACPS: The Aesthetic Center For Plastic Surgery
(877) 707-2277
louis@proagency.com

Source: Dr. Henry Mentz
http://www.drmentz.com

Related Documents:
 Poster 1 Gynecomastia Mentzl.pdf    136.882 KB




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