Gynecomastia; The 5 Zones Concept

INTRODUCTION:

Aesthetic breast area improvements for gynecomastia and gender dysphoria patients who seek a more masculine appearance have increased recently. We present our clinical experience in breast masculinization using and ultrasound liposuction (VASER©).

 

METHODS AND MATERIALS:

Male breast topography was done by dividing each breast into 5 different zones (according to the breast relation to the surrounding muscles), in addition to a special zone of lipo-filling to augment the breast superiorly. The evaluation was performed 6 months after surgery to determine the degree of satisfaction and presence of complications.

 

RESULTS:

Thirty subjects were included in the analysis of this study with mean age of presentation 34.2 (5.5) years with a range from 27 to 49 years old.   Twenty-five patients (83%) had grade II gynecomastia, three patients (10%) were grade III and two patients (7%) were grade IV gynecomastia (according to Rorhrich et al classification system).   The mean BMI was 33.1 (2.1) Kg/m² with a range from 27 to 38. Eighteen (60%) of patient had chest lipo-augmentation, twelve (40%) only had liposculpture without fat injection. Ten (33%) cases had glandular disc excision. Mean volume of Fat injected was 104 (7.2) cc (range; 100-200 cc).
Among the 30 patients, total complications were seven (23.4%). Major complications were 3 (10%) and minor complications were 4 (13.4%)

CONCLUSION:

The new defined zones of the breast acts as a good guide to the surgeons when addressing a case of Gynecomastia. Liposuction and pectoral lipofilling using power-assisted and VASER© techniques are safe and reliable methods for management for gynecomastia with high satisfaction rates and few complications, most of these complications are dealt with using conservative measures without affecting much of the end results and patient’s satisfaction.

KEYWORDS:

Breast masculinization; Gynecomastia; Male; breast; surgical treatment, lipofilling; VASER, Power-assisted, liposuction

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