The Dome technique: A single-stage liposuction and dermopexy treatment for high-grade gynecomastia

Gynecomastia is a benign, excessive development of the male breast that occurs at an overall incidence of 32% to 36%. The goals of surgical treatment are to restore the breast contour with minimal scarring and protect the areolar anatomy and sensation. Here, a new single stage technique is described where peripheral fat tissue is effectively removed using ultrasound-assisted liposuction (UAL) followed by a Dome breast lifting from the superior parabolic periareolar incision without touching the complex inferior pedicle.

A retrospective review of outcomes for 29 patients aged between 18 and 49 years with grade IIB or grade III gynecomastia who were treated with UAL and the Dome technique. Health-related quality-of-life and aesthetic outcomes were evaluated using a modified version of the Breast Evaluation Questionnaire (BEQ).

The mean Likert-type score (LS) increased from 1.82 (18%) preoperatively to 4.10 (81%) months postoperatively (p < 0.05). No infection, nipple-areola complex necrosis, nipple retraction, or saucer deformity was encountered.

The use of UAL and Dome technique for the treatment of severe gynecomastia allows for the effective removal of both the fat and glandular tissue of the breast through a minimal periareolar parabolic incision. This technique can achieve excellent aesthetic results with inconspicuous scarring in a single session.