Comparative evaluation of liposuction to liposuction with endoscope assisted glandular excision in Indian subjects with gynecomastia.

Abstract

Background: Gynecomastia affect nearly 30% of the young males and is been growingly managed using surgical treatments which have shown transition from conventional excision methods to contemporary surgical management as liposuction. There is association of emotional distress when glandular tissue is inadequately assessed, it is vital to assess combined glandular excision and liposuction procedures. Aim: The present study was aimed to comparatively evaluate liposuction to liposuction with endoscope assisted glandular excision in Indian subjects with gynecomastia. Methods: The study assessed 64 subjects with gynecomastia that underwent surgery for gynecomastia within the defined study period. In all the subjects, demographic data were assessed along with medical history and grade of gynecomastia. Surgical procedure done was either liposuction or liposuction with glandular excision. Endoscopy was done to assess fibroglandular tissue presence and need for the glandular excision. Postoperative assessment along with patient questionnaire was assessed at 6 months. Results: In 32 breast surgeries, in 30 subjects, liposuction with glandular excision and 34 subjects, liposuction alone was done. in subjects that underwent liposuction alone, bruising and four hematomas were seen along with puffy nipples that warranted one re-surgery. Glandular excision led to 8 cases of crater deformity and two cases of seroma, hematoma, and superficial skin necrosis each. Cosmetic assessment depicted similar outcomes with higher re-surgeries in liposuction alone group. Conclusion: The present study concludes that combination of glandular excision and liposuction shows comparable results to liposuction alone for management of gynecomastia. Despite the associated complexity, combined liposuction with glandular excision is efficacious and helps in making decision focusing on the need for individualized techniques and for optimum treatment strategies.