Sung Ryul Lee1, Seung Geun Lee2. 1. Department of Surgery, Damsoyu Hospital, 234 Hakdong-ro, Gangnam-gu, Seoul, Republic of Korea. kingsoss@naver.com. 2. Department of Surgery, Damsoyu Hospital, 234 Hakdong-ro, Gangnam-gu, Seoul, Republic of Korea.
Abstract
BACKGROUND: Gynecomastia is a common disease in male patients that is characterized by benign breast enlargement. Gynecomastia may involve fibroglandular tissue (FGT), supramammary fat tissue, and retromammary fat tissue (RMFT). Gynecomastia is usually treated surgically; however, some patients undergo reoperation because of dissatisfaction with the results of the first operation. This study aimed to analyze the breast conditions requiring reoperation and to identify factors requiring attention during the first gynecomastia surgery. METHODS: We retrospectively evaluated 98 patients who underwent reoperation because of unsatisfactory esthetic outcomes from January 2014 to April 2020. According to the reasons for dissatisfaction, patients were divided into undercorrection and overcorrection groups. Patients with remnant breast tissue were assigned to the undercorrection group, while those in whom excess breast tissue was removed and was assigned to the overcorrection group. RESULTS: The undercorrection and overcorrection groups comprised 81 and 17 patients, respectively. In the undercorrection group, 49 (60.5%) patients had residual FGT and fat tissue necessitating simultaneous FGT excision and liposuction, while 32 (39.5%) patients had no residual FGT and were treated with liposuction only. In the overcorrection group, 13 (76.5%) patients had undergone excessive removal of RMFT at the inferolateral aspect of the pectoralis major muscle margin and were treated by autologous fat grafting. CONCLUSIONS: The most common cause of undercorrection was incomplete FGT removal, and the most common cause of overcorrection was excessive RMFT removal. Complete FGT excision and proper RMFT preservation can reduce the reoperation rate after gynecomastia surgery. 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 Table of Contents or the online Instructions to Authors www.springer.com/00266 .
BACKGROUND:Gynecomastia is a common disease in male patients that is characterized by benign breast enlargement. Gynecomastia may involve fibroglandular tissue (FGT), supramammary fat tissue, and retromammary fat tissue (RMFT). Gynecomastia is usually treated surgically; however, some patients undergo reoperation because of dissatisfaction with the results of the first operation. This study aimed to analyze the breast conditions requiring reoperation and to identify factors requiring attention during the first gynecomastia surgery. METHODS: We retrospectively evaluated 98 patients who underwent reoperation because of unsatisfactory esthetic outcomes from January 2014 to April 2020. According to the reasons for dissatisfaction, patients were divided into undercorrection and overcorrection groups. Patients with remnant breast tissue were assigned to the undercorrection group, while those in whom excess breast tissue was removed and was assigned to the overcorrection group. RESULTS: The undercorrection and overcorrection groups comprised 81 and 17 patients, respectively. In the undercorrection group, 49 (60.5%) patients had residual FGT and fat tissue necessitating simultaneous FGT excision and liposuction, while 32 (39.5%) patients had no residual FGT and were treated with liposuction only. In the overcorrection group, 13 (76.5%) patients had undergone excessive removal of RMFT at the inferolateral aspect of the pectoralis major muscle margin and were treated by autologous fat grafting. CONCLUSIONS: The most common cause of undercorrection was incomplete FGT removal, and the most common cause of overcorrection was excessive RMFT removal. Complete FGT excision and proper RMFT preservation can reduce the reoperation rate after gynecomastia surgery. 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 Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Authors: Seung Geun Lee; Pyoung Jae Park; Sung Ryul Lee; Bum Hwan Koo; Geon Young Byun; Myoung Jin Kim; Hyok Jo Kang; Sarang Kim; Beom Seok Oh; Young Hyun Lee Journal: Am J Mens Health Date: 2019 Sep-Oct