MODIFIED SURGICAL TECHNIQUE FOR TREATMENT OF HIGH-GRADE GYNECOMASTIA: A PRELIMINARY STUDY
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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.