[Surgical treatment of gynecomastia: an algorithm]

Area of Science:

• Plastic Surgery
• Surgical Techniques
• Male Breast Reduction

Context:

• Gynecomastia, characterized by male breast enlargement, necessitates tailored surgical approaches.
• Varying degrees of breast volume and skin redundancy present challenges in achieving optimal aesthetic outcomes.
• Previous surgical methods lacked a standardized algorithm for technique selection.

Purpose:

• To introduce and evaluate a novel algorithm for selecting surgical techniques in gynecomastia treatment.
• To correlate specific surgical methods with patient outcomes, including complication rates and satisfaction.
• To provide a structured approach for managing diverse presentations of gynecomastia.

Summary:

• A retrospective review of 118 patients (217 breasts) undergoing surgical gynecomastia correction utilized three techniques based on four severity grades.
• Subcutaneous mastectomy with liposuction (77%), mastopexy (18%), and inferior pedicled mammaplasty (5%) were employed.
• The algorithm resulted in a 4.1% complication rate, with 7.8% requiring revision, and high patient satisfaction (88% good/very good aesthetic results, 83% nipple sensitivity).

Impact:

• The presented algorithm offers a reliable, minimally scarring approach to gynecomastia surgery.
• It facilitates appropriate surgical method selection based on morphological aspects, improving patient outcomes.
• High patient satisfaction and preserved nipple sensitivity demonstrate the algorithm's clinical efficacy.