Journal of Aesthetic & Reconstructive Surgery

Description

Gynecomastia, the benign enlargement of male breast tissue, is a condition that can affect men at various stages of life, ranging from adolescents to older adults. It is typically characterized by the development of glandular breast tissue, which may result in physical discomfort, emotional distress and social embarrassment. This condition often leads to a distorted body image and a significant impact on quality of life. The treatment of gynecomastia has evolved significantly over the years, with both surgical and non-surgical options available. Among the surgical approaches, the combination of a single axillary incision and liposuction has gained popularity due to its minimally invasive nature, excellent aesthetic outcomes and minimal scarring.

Gynecomastia occurs when there is an imbalance between the hormones estrogen and testosterone, leading to the proliferation of glandular tissue in the breast. The condition can result from various factors, including hormonal changes during puberty, the use of certain medications (such as anabolic steroids or anti-androgens), obesity, liver disease and other underlying health conditions. In some cases, gynecomastia may resolve on its own, particularly in adolescents. However, in many instances, it persists into adulthood, causing significant psychological distress and a desire for corrective treatment.

The goal of treatment is to remove the excess glandular tissue, reduce the fat component and improve the contour of the chest while minimizing scarring and avoiding complications.

Role of liposuction in gynecomastia treatment

Liposuction has become a standard technique in the treatment of gynecomastia, especially for cases where there is a predominance of fatty tissue rather than glandular tissue. Liposuction allows for the removal of excess fat through a small cannula, which is inserted through tiny incisions. This technique is minimally invasive, reduces recovery time and offers excellent cosmetic results.

Traditional surgical treatments for gynecomastia often involve incisions around the areola, which can result in noticeable scarring, particularly for patients with larger breasts or excess skin. However, the single axillary incision technique has emerged as an innovative approach that addresses the cosmetic concerns associated with scarring.

Combining liposuction and axillary incision

The treatment typically begins with a thorough assessment of the patient’s gynecomastia, including the extent of glandular tissue and fat. A preoperative consultation allows the surgeon to determine the most appropriate surgical approach, considering factors such as the size of the breasts, the quality of the skin and the degree of glandular versus fatty tissue.

The patient is positioned with the arms raised to allow for proper markings of the axillary area. Local or general anesthesia is administered based on the complexity of the procedure and patient preferences. After the incision is made in the axillary fold, a tumescent solution (a mixture of saline, epinephrine and lidocaine) is injected into the targeted areas to loosen the fat and minimize bleeding. A cannula is then inserted through the incision to aspirate the fat. Liposuction is performed in a systematic manner to ensure even fat removal and optimal contouring. If there is significant glandular tissue present, it is carefully excised through the same incision. This is particularly important in cases of moderate to severe gynecomastia. The surgeon ensures that only the necessary tissue is removed, preserving the natural breast contour. Once the desired amount of fat and glandular tissue is removed, the incision is closed with absorbable sutures. A compression garment is typically worn for several weeks to reduce swelling and help the skin retract. The patient is closely monitored in the recovery room before being discharged.

Recovery from gynecomastia surgery using the single axillary incision and liposuction is typically quick. Most patients experience mild discomfort, which can be managed with pain medications. Swelling and bruising are common but subside within a few weeks. The compression garment helps support the chest and minimize swelling, while also aiding in skin retraction.

The combination of liposuction and a single axillary incision offers a minimally invasive yet highly effective solution for the treatment of gynecomastia. This approach provides excellent cosmetic results with minimal scarring and a short recovery time. It is particularly beneficial for men who wish to achieve a more natural-looking chest contour without the visible scars associated with traditional surgical approaches. As surgical techniques continue to evolve, the single axillary incision combined with liposuction remains a valuable option for men seeking a safe and effective solution for gynecomastia.