Available techniques to minimize scars in surgical management of gynecomastia – a comprehensive review

Objective: Gynecomastia and lipomastia are benign proliferations of the male breast affecting 32–65% of men. Numerous surgical procedures often result in stigmatizing scars when it comes to skin resection. The purpose of this study was to review skin-sparing techniques and to describe our skin-spari...

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Main Authors: G. Frigerio, A. Serre, P.E. Engels, D.F. Kalbermatten, D. André-Lévigne
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:JPRAS Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352587824001426
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author G. Frigerio
A. Serre
P.E. Engels
D.F. Kalbermatten
D. André-Lévigne
author_facet G. Frigerio
A. Serre
P.E. Engels
D.F. Kalbermatten
D. André-Lévigne
author_sort G. Frigerio
collection DOAJ
description Objective: Gynecomastia and lipomastia are benign proliferations of the male breast affecting 32–65% of men. Numerous surgical procedures often result in stigmatizing scars when it comes to skin resection. The purpose of this study was to review skin-sparing techniques and to describe our skin-sparing approach to treat skin excess using transcutaneous netting. Materials and Methods: A comprehensive review of the literature was conducted aiming at identifying available techniques to avoid skin resection in gynecomastia or lipomastia patients (Simon's grade IIb and III). Surgical techniques, patient satisfaction, time of follow-up, and complications were assessed. Results: Seven studies detailed skin retraction techniques, including laser-, ultrasound-, and radiofrequency-assisted liposuction (LAL, UAL, and RAL), microneedling, and nipple-areolar complex (NAC) plaster lifting. All articles provided Simon's grade classification, with most studies including patients with and without skin laxity. Complication rates were low (1.5–10%), and patient satisfaction ranged from 87.5% to 100%.While transcutaneous netting has been reported to reduce hematoma in gynecomastia surgery, no studies specifically examined its role in managing skin redundancy. Conclusions: Limited data exist on scarless skin retraction techniques for gynecomastia. While LAL, UAL, and RAL show some potential, controlled studies are lacking, and skin resection is often performed for high skin redundancy. We recommend a skin-sparing approach using liposuction and transcutaneous netting for gynecomastia up to Simon's grade III, which allows for skin retraction and NAC fixation. No literature was found assessing the efficacy of transcutaneous netting in promoting skin retraction in gynecomastia.
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spelling doaj-art-a7b42cfcd5da4b9e896f6314bb64de6b2024-12-07T08:27:46ZengElsevierJPRAS Open2352-58782024-12-0142256267Available techniques to minimize scars in surgical management of gynecomastia – a comprehensive reviewG. Frigerio0A. Serre1P.E. Engels2D.F. Kalbermatten3D. André-Lévigne4Division of plastic and reconstructive surgery, University Hospital of Geneva, Geneva, SwitzerlandDivision of plastic and reconstructive surgery, University Hospital of Geneva, Geneva, SwitzerlandDivision of plastic and reconstructive surgery, University Hospital of Geneva, Geneva, Switzerland; Regenerative medicine and reconstructive surgery research group, Department of Surgery, University of Geneva, Geneva, SwitzerlandDivision of plastic and reconstructive surgery, University Hospital of Geneva, Geneva, Switzerland; Regenerative medicine and reconstructive surgery research group, Department of Surgery, University of Geneva, Geneva, SwitzerlandDivision of plastic and reconstructive surgery, University Hospital of Geneva, Geneva, Switzerland; Regenerative medicine and reconstructive surgery research group, Department of Surgery, University of Geneva, Geneva, Switzerland; Corresponding author: Dominik André-Lévigne, Division of plastic and reconstructive surgery, University Hospital of Geneva, Geneva, Switzerland. +41 79 553 26 70.Objective: Gynecomastia and lipomastia are benign proliferations of the male breast affecting 32–65% of men. Numerous surgical procedures often result in stigmatizing scars when it comes to skin resection. The purpose of this study was to review skin-sparing techniques and to describe our skin-sparing approach to treat skin excess using transcutaneous netting. Materials and Methods: A comprehensive review of the literature was conducted aiming at identifying available techniques to avoid skin resection in gynecomastia or lipomastia patients (Simon's grade IIb and III). Surgical techniques, patient satisfaction, time of follow-up, and complications were assessed. Results: Seven studies detailed skin retraction techniques, including laser-, ultrasound-, and radiofrequency-assisted liposuction (LAL, UAL, and RAL), microneedling, and nipple-areolar complex (NAC) plaster lifting. All articles provided Simon's grade classification, with most studies including patients with and without skin laxity. Complication rates were low (1.5–10%), and patient satisfaction ranged from 87.5% to 100%.While transcutaneous netting has been reported to reduce hematoma in gynecomastia surgery, no studies specifically examined its role in managing skin redundancy. Conclusions: Limited data exist on scarless skin retraction techniques for gynecomastia. While LAL, UAL, and RAL show some potential, controlled studies are lacking, and skin resection is often performed for high skin redundancy. We recommend a skin-sparing approach using liposuction and transcutaneous netting for gynecomastia up to Simon's grade III, which allows for skin retraction and NAC fixation. No literature was found assessing the efficacy of transcutaneous netting in promoting skin retraction in gynecomastia.http://www.sciencedirect.com/science/article/pii/S2352587824001426GynecomastiaMale chestLiposuctionHemostatic netSkin excessHematoma prevention
spellingShingle G. Frigerio
A. Serre
P.E. Engels
D.F. Kalbermatten
D. André-Lévigne
Available techniques to minimize scars in surgical management of gynecomastia – a comprehensive review
JPRAS Open
Gynecomastia
Male chest
Liposuction
Hemostatic net
Skin excess
Hematoma prevention
title Available techniques to minimize scars in surgical management of gynecomastia – a comprehensive review
title_full Available techniques to minimize scars in surgical management of gynecomastia – a comprehensive review
title_fullStr Available techniques to minimize scars in surgical management of gynecomastia – a comprehensive review
title_full_unstemmed Available techniques to minimize scars in surgical management of gynecomastia – a comprehensive review
title_short Available techniques to minimize scars in surgical management of gynecomastia – a comprehensive review
title_sort available techniques to minimize scars in surgical management of gynecomastia a comprehensive review
topic Gynecomastia
Male chest
Liposuction
Hemostatic net
Skin excess
Hematoma prevention
url http://www.sciencedirect.com/science/article/pii/S2352587824001426
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