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Luo C, Zhang S, Wei C, Guo Y, Zhang Y. The Scar-Hidden Surgery on Gynecomastia: Experiences from a Single-Institutional Large Case Series. Aesthetic Plast Surg 2024:10.1007/s00266-024-04111-0. [PMID: 38886195 DOI: 10.1007/s00266-024-04111-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 04/25/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND To summarize the experiences on the mastoscopic subcutaneous mastectomy for gynecomastia by "nine-step method" based on the "5S" goal and standardize this operation. PATIENTS AND METHODS Between January 1, 2002, and October 31, 2021, a total of 2035 breasts of 1082 male patients with gynecomastia, of which 129 patients with one side, were underwent mastoscopic subcutaneous mastectomy. The follow-up endpoint was 3 months after surgery. RESULTS All patients were successfully completed the operation, and none of them was transferred to open operation. The operation time for unilateral breast was 12-28 min, and the average time was 17.7 ± 6.2 min. The amount of bleeding during unilateral operation was very small, about 5-10 ml. The total drainage volume was 5-50 ml after the operation, and the drainage tube was removed in 3-5 days. The epidermal necrosis occurred in 0.3% nipple. 0.2% chest wall had a little ecchymosis in the supero-medial region of the breast. All patients had the normal feeling of nipples and areola, the smoothing and symmetrical chest wall, and the natural contour. There was no recurrence during the follow-up period. CONCLUSIONS The mastoscopic subcutaneous mastectomy for gynecomastia by "nine-step method" based on the "5S" goal has a short operation time, few surgical complications and good esthetics. It achieves the "5S" goals on the complete removal of glandular tissue (sweeping), small and scar-hidden incision are small (scarless), good symmetry of bilateral chest wall (symmetry), normal chest shape (shape), and smoothing chest wall (smoothing). LEVEL OF EVIDENCE III The journal asks authors to assign a level of evidence to each article. For a complete description of Evidence-Based Medicine ratings, see the Table of Contents or the online Instructions for Authors at www.springer.com/00266 .
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Affiliation(s)
- Chengyu Luo
- Breast surgery, Affiliated Beijing Anzhen Hospital, Capital Medical University, No 2 Anzhen road, Chaoyang district, Beijing, 100029, China.
| | - Shuqi Zhang
- Breast surgery, Affiliated Beijing Anzhen Hospital, Capital Medical University, No 2 Anzhen road, Chaoyang district, Beijing, 100029, China
| | - Changsheng Wei
- Breast surgery, Affiliated Beijing Anzhen Hospital, Capital Medical University, No 2 Anzhen road, Chaoyang district, Beijing, 100029, China
| | - Yang Guo
- Breast surgery, Affiliated Beijing Anzhen Hospital, Capital Medical University, No 2 Anzhen road, Chaoyang district, Beijing, 100029, China
| | - Yajing Zhang
- Breast surgery, Affiliated Beijing Anzhen Hospital, Capital Medical University, No 2 Anzhen road, Chaoyang district, Beijing, 100029, China
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Pant A, Kannan A, Nagaraju N, Sinha S, Singh J, Paruthy E, Sundaramurthi S. Clinical Outcomes of Liposuction Assisted Gynecomastia Surgery with Minimal Periareolar Incision. Aesthetic Plast Surg 2023; 47:95-96. [PMID: 35831754 DOI: 10.1007/s00266-022-03000-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 06/18/2022] [Indexed: 11/01/2022]
Affiliation(s)
- Arjun Pant
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, 605009, India
| | - Amudhan Kannan
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, 605009, India
| | - Nidhi Nagaraju
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, 605009, India
| | - Sarthak Sinha
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, 605009, India
| | - Jaiveer Singh
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, 605009, India
| | - Enakshi Paruthy
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, 605009, India
| | - Sudharsanan Sundaramurthi
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, 605009, India.
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Shang F, Zhao Z, Li Z, Liu B. The combination of endoscopic subcutaneous mastectomy and liposuction (Liu and Shang's 2-hole 7-step method) as the treatment of gynecomastia. Surgery 2023:S0039-6060(23)00198-8. [PMID: 37198036 DOI: 10.1016/j.surg.2023.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 02/26/2023] [Accepted: 04/09/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Most patients suffering from gynecomastia require treatment to maintain a smooth subcutaneous tissue contour, remove loose skin, and leave a suitable nipple-areolar complex with minimal scarring; hence, surgery has become the prime choice to treat gynecomastia. Based on our experience, Liu and Shang's 2-hole 7-step method works well for these patients. METHODS From November 2021 to November 2022, a total of 101 gynecomastia patients featuring various Simon grades were included in this study. The patients' basic condition and surgical procedure were recorded in detail. A score of 1 to 5 was given for 6 main aesthetic aspects. RESULTS With Liu and Shang's 2-hole 7-step method, the operations were successfully completed in all 101 patients. Six patients had Simon grade I, 21 grade IIA, 56 grade IIB, and 18 grade III. The average surgery time was 86.54 (range = 46-144) minutes. The average intraoperative blood loss was 22.7 (range = 10 ∼ 75) mL. The average postoperative drainage time was 2.35 (range = 1-4) days, the drainage volume was 83.35 (range = 13∼240) mL, and the drainage mainly occurred on the first postoperative day. The scores on all 6 aesthetic aspects were >4 points, which fully affirmed the aesthetic effect of this method. CONCLUSION Liu and Shang's 2-hole 7-step method is safe and feasible for treating gynecomastia and has been fully affirmed for its efficacy and cosmetic effect. It can be the main option for minimally invasive surgery to treat gynecomastia.
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Affiliation(s)
- Fangjian Shang
- Department of General Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, P.R. China
| | - Zengren Zhao
- Department of General Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, P.R. China
| | - Zhongxin Li
- Department of General Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, P.R. China
| | - Bo Liu
- Department of General Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, P.R. China.
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He W, Wei W, Zhang Q, Lv R, Qu S, Huang X, Ma J, Zhang P, Zhai H, Wang N. A retrospective cohort study of tamoxifen versus surgical treatment for ER-positive gynecomastia. BMC Endocr Disord 2023; 23:62. [PMID: 36915127 PMCID: PMC10010038 DOI: 10.1186/s12902-023-01310-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 02/28/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Gynecomastia is a common condition in clinical practice. The present study aimed to review the clinical data of ER-positive gynecomastia patients treated by tamoxifen (TAM) versus surgery and discussed the clinical effects of the two treatment strategies. METHOD We retrospectively collected the clinical indicators of patients with unilateral or bilateral gynecomastia who received treatment at our hospital between April 2018 and December 2021. Depending on the treatment received, the patients were divided into TAM and surgery groups. RESULT A total of 170 patients were recruited, including 91 patients in TAM group and 79 patients in surgery group. The age of the patients differed significantly between the TAM and surgery groups (P < 0.01). The estrogen level was closer in patients with stable and progressive disease, but significantly different in patients of glandular shrinkage in TAM group (P < 0.01). The proportion of patients achieving stable disease was higher among those with clinical grade 1-2. Among patients classified as clinical grade 3, the proportion of patients achieving glandular shrinkage of the breast was higher after TAM treatment (P < 0.05). The age and length of hospital stay were significantly different in patients undergoing open surgery than minimally invasive rotary cutting surgery and mammoscopic-assisted glandular resection (P < 0.01). Patients had significantly different complications including mild postoperative pain, hematoma, nipple necrosis, nipple paresthesias and effusions among the surgery subgroups (all P < 0.05). The estrogen level and the type of surgery were significantly different between the surgical recurrence and non-recurrence subgroups (P < 0.05). The difference in the thickness of glandular tissues upon the color Doppler ultrasound also reached a statistical significance between the two groups (P = 0.050). An elevated estrogen level was a factor leading to TAM failure. Among surgical patients, the thickness of glandular tissues, estrogen level, and type of surgery performed were risk factors for postoperative recurrence (all P < 0.05). CONCLUSION Both treatment strategies can effectively treat gynecomastia, but different treatment methods can benefit different patients. TAM treatment is more beneficial than surgery for patients who cannot tolerate surgery, have a low estrogen level, and are clinical grade 1-2. Surgery treatment is better than TAM for patients of clinical grade 3. Different surgery options may lead to different complications. Patients with a greater glandular tissue thickness and a higher estrogen level were shown to have a higher risk of recurrence.
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Affiliation(s)
- Weili He
- Department of Breast Surgery, the First Affiliated Hospital of Jinan University, 510630, Guangzhou, China
| | - Weidong Wei
- Department of Breast Surgery, Sun Yat-sen University Cancer Center, 510630, Guangzhou, China
| | - Qing Zhang
- Department of Breast Surgery, the First Affiliated Hospital of Jinan University, 510630, Guangzhou, China
| | - Rongzhao Lv
- Department of Breast Surgery, the First Affiliated Hospital of Jinan University, 510630, Guangzhou, China
| | - Shaohua Qu
- Department of Breast Surgery, the First Affiliated Hospital of Jinan University, 510630, Guangzhou, China
| | - Xin Huang
- Department of Breast Surgery, the First Affiliated Hospital of Jinan University, 510630, Guangzhou, China
| | - Juan Ma
- Department of Laboratory, the First Affiliated Hospital of Jinan University, 510630, Guangzhou, China
| | - Ping Zhang
- Department of Ultrasonography, the First Affiliated Hospital of Jinan University, 510630, Guangzhou, China
| | - Hening Zhai
- Department of Digestive Endoscopy c Center, the First/Fifth Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Tianhe District, 510630, Guangzhou, China.
| | - Ningxia Wang
- Department of Breast Surgery, the First Affiliated Hospital of Jinan University, 510630, Guangzhou, China.
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Fei X, Song R, Yu X, Zhang S, Zhang Y, Gao Y, Bi D, Yao S, Cui J. The clinical significance of complete process management for the quality control of horizontal rotational resection of a breast mass. Heliyon 2023; 9:e13537. [PMID: 36865481 PMCID: PMC9970895 DOI: 10.1016/j.heliyon.2023.e13537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 02/02/2023] [Accepted: 02/02/2023] [Indexed: 02/09/2023] Open
Abstract
Objective To explore the clinical outcomes of the complete process management of horizontal rotational resection of a breast mass. Methods A retrospective study was conducted involving 638 patients who underwent horizontal rotational resection of breast tissue in the Department of Thyroid and Breast Surgery of the People's Hospital of China Medical University from August 2018 to August 2020 using the ultrasound Breast Imaging-Reporting and Data System (BI-RADS) classification of 4A and below. These patients were divided into the experimental group and the control group based on whether the surgery had been performed following the order of the complete process management. The time cutoff point for the two groups was June 2019. The propensity score matching method was used to implement 1:1 ratio matching according to age, mass size, location, ultrasound BI-RADS classification, and breast size (measured by basal diameter), and the patients in the two groups were compared for the duration of surgery (the time needed to performed the three-step 3D positioning), postoperative skin hematoma and ecchymosis, postoperative pathological malignancy rate, residual rate of the mass, and satisfaction rate. Results After 278 pairs were matched, no statistically significant differences were found between the two groups in terms of demographics (P > 0.05). The duration of surgery in the experimental group was significantly shorter compared with the control group (7.90 ± 2.18 min vs. 10.20 ± 5.99 min, respectively; P < 0.05); the satisfaction score in the experimental group (8.33 ± 1.36) was higher compared with the control group (6.48 ± 1.22) (P < 0.05); the malignant and residual rates of mass in the experimental group were lower than those in the control group, i.e., 6 vs. 21 cases (P < 0.05), and 4 vs. 16 cases, respectively (P < 0.05); the incidence of skin hematoma and ecchymosis was lower in the experimental group, i.e., 3 vs. 21 cases (P < 0.05). Conclusion Complete process management for horizontal rotational resection of a breast mass can shorten the duration of surgery, reduce the residual mass, postoperative bleeding, and postoperative malignancy rates, and improve the breast preservation rate and patient satisfaction. Accordingly, its popularization represents research value.
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Affiliation(s)
- Xiang Fei
- Department of Thyroid and Breast Surgery, People’s Hospital of China Medical University (Liaoning Provincial People’s Hospital), Shenyang, 110016, China
| | - Renfeng Song
- Department of General Surgery, First People’s Hospital of Huangzhong District, Xining, Qinghai Province, Xining, 056400, China
| | - Xuewei Yu
- Department of General Surgery, First People’s Hospital of Huangzhong District, Xining, Qinghai Province, Xining, 056400, China
| | - Siyuan Zhang
- Department of Breast and Thyroid Surgery, Beitun General Hospital of Tenth Division, Xinjiang Production and Construction Corps, Beitun, 836000, China
| | - Ying Zhang
- Department of Thyroid and Breast Surgery, People’s Hospital of China Medical University (Liaoning Provincial People’s Hospital), Shenyang, 110016, China
| | - Yang Gao
- Department of Thyroid and Breast Surgery, People’s Hospital of China Medical University (Liaoning Provincial People’s Hospital), Shenyang, 110016, China
| | - Dongning Bi
- Department of Thyroid and Breast Surgery, People’s Hospital of China Medical University (Liaoning Provincial People’s Hospital), Shenyang, 110016, China
| | - Shengsheng Yao
- Department of Thyroid and Breast Surgery, People’s Hospital of China Medical University (Liaoning Provincial People’s Hospital), Shenyang, 110016, China
| | - Jianchun Cui
- Department of Thyroid and Breast Surgery, People’s Hospital of China Medical University (Liaoning Provincial People’s Hospital), Shenyang, 110016, China,Corresponding author.
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Liu C, Tong Y, Sun F, Zhang C, Yu Z, Yu P, Pan H, Zhou W, Shi J, Zhao Y. Endoscope-Assisted Minimally Invasive Surgery for the Treatment of Glandular Gynecomastia. Aesthetic Plast Surg 2022; 46:2655-2664. [PMID: 35237883 DOI: 10.1007/s00266-022-02807-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 01/27/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Gynecomastia (GYN) is the most common benign disease in males. A vacuum-assisted biopsy is a minimally invasive surgical technique for GYN treatment that achieves satisfactory aesthetic results. However, due to the operation under non-direct vision, it is difficult to localize the bleeding points and assess the residual glandular tissue. Endoscopy was applied to observe the operative field after subcutaneous mastectomy. The present study aimed to recommend our initial experience in glandular GYN with endoscope-assisted minimally invasive subcutaneous mastectomy. METHODS A total of 34 patients diagnosed with glandular GYN (50 breasts), treated with endoscope-assisted minimally invasive surgery at The First Affiliated Hospital with Nanjing Medical University between June 2018 and June 2020, were enrolled in this study. According to Simon's classification of the breast, 10 was grade I, 25 was grade IIA, and 15 was grade IIB. The characteristics of patients, operative data, postoperative complications, cosmetic outcome, and patient satisfaction were recorded. RESULTS Endoscope-assisted minimally invasive mastectomy was performed successfully in all cases. The operative duration of the operation was 55-120 min/side. The total weight of the resected tissue of the 50 breasts was 55-350 g, and the blood loss was 10-105 mL/breast. Endoscopy detected five breasts with bleeding and three with residual glandular during the operation. Postoperative bleeding occurred in 1 breast, subcutaneous seroma in 3 breasts, dysesthesia of the nipple-areolar complex in 2 breasts, and skin redundancy in a bilateral patient. None of the patients experienced severe pain, infection, nipple necrosis, and nipple retraction, a saucer-like deformity. With a median follow-up of 21 months, all patients were satisfied with their cosmetic outcome (100%), and no recurrence occurred. CONCLUSION Endoscope-assisted minimally invasive mastectomy could be used as a feasible technique for the treatment of glandular GYN. LEVEL OF EVIDENCE IV 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 .
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Affiliation(s)
- Congcong Liu
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Ying Tong
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Feixiang Sun
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Chuanpeng Zhang
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Ziyi Yu
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Pan Yu
- Department of Plastic Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Hong Pan
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Wenbin Zhou
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Jingping Shi
- Department of Plastic Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Yi Zhao
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
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Hong JY, Park SJ, Kim SY, Kim BJ. Efficacy and Safety of Cold-Induced Noninvasive Targeted Fat Reduction in Pseudogynecomastia. Ann Dermatol 2022; 34:412-418. [PMID: 36478423 PMCID: PMC9763905 DOI: 10.5021/ad.21.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 04/20/2022] [Accepted: 08/01/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Treatment options for pseudogynecomastia are limited, and the demand for noninvasive breast fat reduction is increasing. OBJECTIVE We evaluated the efficacy and safety of a cold-induced lipolysis device for treating pseudogynecomastia. METHODS In this 16-week prospective trial, a total of 15 male patients with pseudogynecomastia were treated twice with cryolipolysis. The primary endpoint was a change in the chest circumference from baseline at posttreatment week 8. Secondary endpoints were changes in body weight, fat thickness assessed using ultrasonography, independent evaluator- and patient-rated improvement, and Simon's gynecomastia class (SGC) grading. RESULTS The primary assessment, a reduction of 3.05 cm in the mean chest circumference at 8 weeks post-treatment compared to baseline, was statistically significant. The treatment effect was cumulative, with a steady decrease in chest circumference and fat thickness over the 16-week study period. The mean pain score immediately after the first session of treatment was 2.0±1.36, based on a scale of 0~10, with a score of 10 being the worst pain ever experienced. The pain decreased substantially after the end of the procedure. CONCLUSION Cryolipolysis was demonstrated to be an effective and safe option for reducing breast fat in pseudogynecomastia. Male with mild to moderate breast enlargement without skin excess can be ideal candidates.
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Affiliation(s)
- Ji Yeon Hong
- Department of Dermatology, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Su Jung Park
- Department of Dermatology, Chungnam National University Sejong Hospital, Sejong, Korea.,Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | | | - Beom Joon Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
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8
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Yao Q, Zhai H, Huang H, Lin J, He W. A comparative study of the efficacy of tamoxifen and Chinese patented medicine (Pingxiao capsules) in gynecomastia: A retrospective cohort study. Andrologia 2022; 54:e14640. [DOI: 10.1111/and.14640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/27/2022] [Accepted: 10/29/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Qianli Yao
- Department of Breast Surgery The First Affiliated Hospital of Jinan University Guangzhou China
| | - Hening Zhai
- Department of Digestive Endoscopy Center The First/Fifth Affiliated Hospital of Jinan University Guangzhou China
| | - Hailang Huang
- Department of General Surgery Guizhou Moutai Hospital Renhuai Guizhou China
| | - Junnan Lin
- Department of Cardiothoracic Surgery The First Affiliated Hospital of Jinan University Guangzhou China
- Department of Nursing Chaoshan Hospital, The First Affiliated Hospital of Jinan University Chaozhou China
| | - Weili He
- Department of Breast Surgery The First Affiliated Hospital of Jinan University Guangzhou China
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Approach to gynecomastia and pseudogynecomastia surgical techniques and its outcome: a systematic review. J Plast Reconstr Aesthet Surg 2022; 75:1704-1728. [DOI: 10.1016/j.bjps.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 01/17/2022] [Accepted: 02/12/2022] [Indexed: 11/17/2022]
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10
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Comparison of Curative Complications between Mammotome-Assisted Minimally Invasive Resection and Conventional Open Resection for Breast Neoplasm: A Retrospective Clinical Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:7739628. [PMID: 34840980 PMCID: PMC8612774 DOI: 10.1155/2021/7739628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/20/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022]
Abstract
Background To know the clinical value of mammotome-assisted minimally invasive resection (MAMIR) in the treatment of patients with breast neoplasm, we performed a retrospective clinical study for the patients treated with the MAMIR and conventional open resection (COR). Methods Postoperative complications were compared between 40 patients treated with the MAMIR and 40 patients treated with the COR. The postoperative complications mainly included intraoperative blood loss, hospitalization days, operative time, surgical scar, and incidence of postoperative complications. Results We found that the amount of intraoperative blood loss, hospitalization days, operative time, surgical scar, and incidence of postoperative complications in the MAMIR group were significantly lower than those of patients in the COR group. Conclusion Our results indicated that patients with breast neoplasm treated with the MAMIR had better outcomes, which reinforced the advantage of this approach.
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Kapoor R, Dharmalingam GC, Sonkar AA, Anand A, Agrawal MK, Gaurav K. Endoscopic subcutaneous mastectomy plus liposuction via a single axillary incision for gynecomastia: Views from developing world. Surgery 2021; 171:1704-1707. [PMID: 34819235 DOI: 10.1016/j.surg.2021.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Rohan Kapoor
- Department of Surgery, King George's Medical University, Lucknow, India.
| | | | | | - Akshay Anand
- Department of Surgery, King George's Medical University, Lucknow, India
| | | | - Kushagra Gaurav
- Department of Surgery, King George's Medical University, Lucknow, India
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Invited Discussion on: The Vacuum-Assisted Breast Biopsy System is an Effective Strategy for the Treatment of Gynecomastia. Aesthetic Plast Surg 2021; 45:411-412. [PMID: 32926188 DOI: 10.1007/s00266-020-01956-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 10/23/2022]
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13
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The Vacuum-Assisted Breast Biopsy System is an Effective Strategy for the Treatment of Gynecomastia. Aesthetic Plast Surg 2021; 45:404-410. [PMID: 32886161 DOI: 10.1007/s00266-020-01931-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 08/16/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Gynecomastia is the most common benign disease in males with an increasing prevalence in recent years. It may cause local pain and psychological disorders. The vacuum-assisted breast biopsy system has been reported to be a novel surgical approach for the treatment of gynecomastia. However, there are little detailed reports comparing the curative effect between traditional surgery and vacuum-assisted breast biopsy for gynecomastia. Besides, there was little study which compared the application of two different systems for the treatment of gynecomastia. Our study aimed to investigate the effectiveness of vacuum-assisted breast biopsy systems for patients with gynecomastia. METHODS We retrospectively reviewed 83 patients with gynecomastia between January 2015 and December 2019. Open surgery was performed in 56 patients, and vacuum-assisted breast biopsy was performed in 27 patients. The characteristics of patients as well as the curative effects between the two groups were analyzed. The two vacuum-assisted breast biopsy systems (Mammotome and Encor) were performed for the patients with gynecomastia. The efficacy, safety, complications, and patient satisfactions were recorded during postoperative follow-up periods. RESULTS Compared with the open surgery group, the vacuum-assisted breast biopsy group had significantly smaller scar sizes left after the operation (5.5 ± 1.3 cm vs 0.8 ± 0.2 cm, p < 0.001), and shorter hospital stay time (5.5 ± 2.4 ds vs 3.1 ± 1.6 ds, p < 0.001). Patients in vacuum-assisted breast biopsy group had a better cosmetic outcome than those in open surgery group. There were no statistically significant differences between the two vacuum-assisted breast biopsy systems according to the mean age, the mean operation time, sites, or grade. In addition, no serious complications were observed in vacuum-assisted breast biopsy group. All the patients recovered well and were satisfied with the cosmetic outcomes. CONCLUSION The vacuum-assisted breast biopsy system can be used as a feasible and minimally invasive approach for the treatment of gynecomastia. LEVEL OF EVIDENCE IV 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 .
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Yang Y, Mu D, Xu B, Li W, Zhang X, Lin Y, Li H. Endoscopic subcutaneous mastectomy plus liposuction via a single axillary incision for gynecomastia in Asian patients: A report of 45 cases. Surgery 2021; 170:39-46. [PMID: 33715850 DOI: 10.1016/j.surg.2021.01.046] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 01/21/2021] [Accepted: 01/25/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Most techniques for surgical correction of gynecomastia are performed by anterior and/or lateral chest incisions, showing an "operated" appearance. Our initial experience was introduced in gynecomastia with a combination of endoscopic subcutaneous mastectomy and liposuction via an axillary single incision. METHODS Between September 2018 and July 2019, a series of 45 male patients who had Simon grade I or II gynecomastia were enrolled in this study. The demographics, operative data, and postoperative complications were recorded in detail. Four independent observers gave their ratings by assigning scores of 1 to 5 for 6 main aesthetic aspects based on pre and postoperative photographs. RESULTS Endoscopic subcutaneous mastectomy combined with liposuction via an axillary single incision was performed successfully in all cases. Mean operative duration was 82.6 minutes for each side (37.5-132.5 minutes). The weight of the resected glandular tissue of the 89 breasts was 26 to 130 g and the aspiration volume was 60 to 700 mL. Three unilateral subcutaneous seromas (3.3%), 5 unilateral hematomas (5.6%), and 1 bilateral minimal skin redundancy (2.2%) were encountered. Observer-reported outcomes indicated that patients with grade Ⅰ gynecomastia had significantly better aesthetic results than those with grade Ⅱb in the aspects of symmetry, shape of nipple, shape of areola, contour regularity, and overall appearance (P < .001). Patients with grade Ⅱa gynecomastia also witnessed better improvement than grade Ⅱb in shape of nipple, contour regularity, and overall appearance (P < .05). CONCLUSION Endoscopic subcutaneous mastectomy combined with liposuction via an axillary single incision is a feasible minimally invasive technique for the treatment of gynecomastia. The combined method is effective in achieving satisfied aesthetic results for Simon grades I and Ⅱa gynecomastia, and it can also be an alternative choice for grade Ⅱb.
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Affiliation(s)
- Yan Yang
- Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Dali Mu
- Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
| | - Boyang Xu
- Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Wandi Li
- Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Xiaoyu Zhang
- Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Yan Lin
- Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Haoran Li
- Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
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