The Need of Glandular Excision After Convantional Liposuction in Gynecomastia

INTRODUCTION: Gynecomastia refers to benign enlargement of male mammary tissue as a result of an increase of glandular, ductal, or adiposal components. In this study, we aimed to investigate the need of glandular excision after conventional liposuction in gynecomastia based on the intraoperative evaluation of surgeons.
METHODS: We reviewed the medical records of males who were operated for gynecomastia between 2013 and 2017. Although all breasts were operated with the liposuction, a glandular excision was also applied to the breasts that were needed depending on the surgeon’s intraoperative evaluation.
RESULTS: A total of 99 breasts (5 unilateral, 47 bilateral) were operated in 52 males (mean age 25.61 years, mean follow-up: 21.5 months). A total of 71 (71.7%) breasts were operated with liposuction alone. The remaining 28 (28.2%) breasts were operated with liposuction followed by glandular excision. Only 8 (11.2%) breasts that underwent liposuction alone needed a revision with glandular re-excision 6 months later. When 8 breasts operated with ductal excision were added, 36 (36.3%) of 99 breasts were operated with liposuction+resection.
DISCUSSION AND CONCLUSION: This retrospective study showed that liposuction alone provided satisfactory results in about two thirds of breasts with gynecomastia whereas glandular re-excision becomes necessary in addition to liposuction in a third of patients. Glandular excision should not be avoided when an obvious glandular tissue remained in intraoperative physical examination following liposuction.

Jinekomasti Tedavisinde Konvansiyonel Liposuction Sonrasý Glandüler Eksizyon Ýhtiyacý

GÝRÝÞ ve AMAÇ: Jinekomasti, glandüler, duktal veya adipozal bileþenlerin artmasý sonucu erkek meme dokusunun iyi huylu büyümesidir. Bu çalýþmada, jinekomasti tedavisinde cerrahýn intraoperatif deðerlendirmesine baðlý olarak konvansiyonel liposuctiondan yapýldýktan sonra glandüler eksizyon gereksinimini araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: 2013 ve 2017 yýllarý arasýnda jinekomasti nedeniyle ameliyat edilen erkek hastalarýn tibbi kayýtlarý retrospektif olarak incelendi. Tüm jinekomastili erkek memeleri liposuction yöntemi ile ameliyat edildikten sonra cerrahlarýn intraoperatif deðerlendirmesine baðlý olarak ihtiyaç duyulan memelere glandüler eksizyon da uygulandý.
BULGULAR: 52 erkekte (ortalama 25.61 yýl, ortalama takip: 21.5 ay) toplam 99 meme (5 tek taraflý, 47 bilateral) ameliyat edildi. Toplam 71 (% 71.7) memeye sadece liposuction uygulandý. Geriye kalan 28 (% 28.2) meme, liposuction ve ardýndan glandüler eksizyon ile ameliyat edildi. Tek baþýna liposuction uygulanan 8 (% 11.2) memede, takiplerde revizyon ihtiyacý olduðu görüldü ve 6 ay sonra glandüer eksizyon uygulandý. Duktal eksizyon ile ameliyat edilen 8 meme eklendiðinde, 99 memenin 36'sýna (% 36.3) liposuction + rezeksiyon uygulanmýþtýr.
TARTIÞMA ve SONUÇ: Retrospektif olarak yapýlan bu çalýþmada görülmüþtür ki jinekomasti nedeniyle ameliyata alýnan memelerin yaklaþýk olarak üçte ikisinde liposuction tek baþýna yeterli bir cerrahi saðlarken üçte birinde liposuction ile beraber glandüler eksizyon gerekmektedir. Ýntraoperative olarak liposuction sonrasý fizik muayene ile bariz glanduler doku kalmýþ hastalarda glandüler eksizyon uygulamasýndan kaçýnýlmamalýdýr.