Liposuction reduces surgical time for mastectomy in gynecomastia

Mastectomy and liposuction are the most used techniques for the treatment of pubertal gynecomastia. This study compared the surgical time and safety of the combined technique versus isolated mastectomy.

A retrospective single-center study was conducted in males with bilateral gynecomastia treated between 2005 and 2022. Patients with synchronous double-field approach, operated by specialists, with prior endocrinological evaluation and a minimum follow-up of 2 years, were included. Two cohorts were established depending on whether or not tumescent liposuction with Klein's solution was associated. Age, BMI, and Simon grade were analyzed, along with intraoperative variables (glandular weight, operative time, and need for drainage), postoperative outcomes, complications, and reinterventions. The analysis was performed with SPSS v20 (statistical significance p<0.05).

Of 96 patients, 39 met the criteria: 13 were treated with mastectomy and 26 with the combined technique. The groups were comparable in age, BMI, and gynecomastia grade. The mean glandular weight was 65 vs. 51 g. Combined surgery showed a significantly shorter surgical time (82 vs. 123 min; p<0.005). There were no differences in the placement of drains (2 vs. 1; p= 1). The complication rate was similar: no infections were recorded, and hematomas were 1 vs. 3 (p= 0.06). Global satisfaction was high in both groups (96% vs. 92%). No reoperations were described, with a minimum follow-up of 2 years.

The combination of tumescent liposuction and mastectomy significantly reduces operative time, without increasing morbidity or the need for reinterventions.