Analysis of Nipple-Areola Complex Localization Using Male Cadavers: Considerations for Gender-Affirming Surgery

Simultaneous Treatment of Pseudo-gynecomastia and Lateral Chest in Patients with Massive Weight Loss

BACKGROUND

Pseudogynecomastia in MWL patients is characterized by excess skin in chest, lateral chest, axilla and upper abdomen without enlargement of the breast glandular component. The aim of this work was to study long-term aesthetic outcomes of correction of severe pseudogynecomastia post-weight loss with inferior pedicle technique with some refinements.

METHODOLOGY

This prospective study included 15 patients underwent chest contouring after massive weight loss within period of 2 years between January 2022 and January 2024. All patients were subjected to local examination (position of nipple-areola complex and degree of ptosis and chest anthropometry) and photographic assessment, and pre- and postoperative results were compared. Patient satisfaction survey was done.

RESULTS

The ages ranged from 20 to 45 years (mean 32.67 years), the previous weight ranged with mean 158.8, the mean current weight was 87.53, and the mean BMI was 28.49. The time of weight loss ranged from 8 to 48 months (mean 20.07 months), and the duration of weight stability ranged from 6 to 24 months with mean 10.0 months. Regarding the complications, no major complications required readmission, four patients had minor complications (26.7%), one (6.7%) case had asymmetry of the NAC, one (6.7%) case had minor hematoma, one (6.7%) case had seroma, and one (6.7%) case had partial wound dehiscence. The overall satisfaction rate was high.

CONCLUSION

Patient satisfaction with male chest contouring for pseudogynecomastia following significant weight loss is excellent. In this study, we provide a reliable technique for management of pseudogynecomastia in post-MWL with good outcomes.

LEVEL OF EVIDENCE IV

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The clinical anatomy fellowship: A participants' perspective

Kansas City University offers a Clinical Anatomy Fellowship which enrolls nine medical students during each academic year and provides training in research, teaching, and advanced anatomical topics. The Fellows practice as novice educators, working alongside Anatomy faculty to teach medical students in the Gross Anatomy laboratory. However, little has been reported related to Fellowship participation and success outcomes. This survey-based study was designed to explore (1) student motivation(s) for pursuing the Fellowship, (2) benefits of participation, and (3) the perceived impact on residency applications and career success. Three unique populations were surveyed. The most important factors driving application to the Fellowship were a desire to increase competitiveness in the residency application process (Likert mean score 4.7-5.0) and a passion for Anatomy (Likert mean score 4.3-4.7). Taking a year away from the College of Osteopathic Medicine curriculum (Likert mean score 4.4) and delaying clinical exposure (Likert mean score 4.2) were the most important deterrents to application. The most reported benefits after program completion included opportunities to build a strong residency application (44% and 50% of Fellows), conduct research (44% and 45% of Fellows), and participate in teaching (11% and 50% of Fellows). 73% of past Fellows matched into their top specialty of choice. Flexibility in the program allows participants to individualize their Fellowship experience to address their personal goals related to residency applications and careers as future physicians. As the results suggest, the Clinical Anatomy Fellowship benefits Fellows, signaling other medical institutions to consider adopting a similar program.