This study was designed to evaluate the outcome of a modified surgical
approach for management of Simort's II and III gynecomastia. Fourteen
patients with idiopathic gynecomastia (9 unilateral and 5 bilateral)
were enrolled in the study. A preareolar incision was performed at the
upper half of the areolar-cutaneous line, then another curved incision was
made cephalad to the first incision and was extended so as both ends of
both incision met and thus giving a picture of an elliptical incision with
the width of the ellipse varied according to the surface area of skin determined,
preoperatively, to be excised. All fibrofatty tissue was dissected
and excised and surgical field was drained. The surgical procedure was
completed straightforward without in.traoperative problems with a mean
duration of surgery being 35 for unilateral and 56 minutes for bilateral
cases. Suction drains were removed after 4-5 days in most patients. One
month after surgery, all patients had achieved a good aesthetic contour of
the chest and were satisfied. but as regards wound appearance, 3 patients
were partially satisfied; 2 patients had excess wound edge (dogear)
that re-corrected under local anesthesia and one patient has bilateral?
y corrugated scar, and only one patient was unsatisfied by the color of
the areola and nipple. It could be concluded that the use of a semicircular
incision placed at the upper areolar-cutaneous Junction combined with a
cepholnd positioned curved incision is a good approach for the treatment
of high-grade gynecomastia allowed excellent access for glandular excision
with preservation of quite sufficient blood supply to the nipple-areola
complex, with urtapparent preareolar scar and symmetrical non-ptosed
areola or nipple. |
