Combined use of ultrasonic-assisted Liposuction and semicircular periareolar incision for the treatment of gynecomastia

Background: Of the wide range of excisional and liposuction techniques used to correct gynecomastia, so far, no single one was suitable for all grades of gynecomastia. We introduce ultrasonic-assisted liposuction (UAL) combined with conventional liposuction, and partial gland resection without skin excision as the standard surgical technique for all such grades.. Patients and Methods: Twenty-eight men (aged 17 to 80 years) were consecutively treated from March 2004 through April 2006 for grade la (n = 3), Ib (n = 2), IIa (n = 6), IIb (n = 6), 111 (n = 8), or IV (n = 3) gynecomastia. Their characteristics and the outcome of surgery were retrospectively assessed. Results: A mean of 848 mL (range, 300 to 1400 mL) of liquefied breast tissue was aspirated, and 31 g (range, 3 to 180 g) of fibroglandular tissue were excised per breast. No immediate or delayed adjuvant skin reduction was needed in any of the patients. Moderate postoperative ecchymosis was observed in 2 patients, but no complications were encountered in this series. The cosmetic outcome was good to excellent in all. Conclusions: UAL in combination with gland resection through a minimal caudal semicircular periareolar incision and conventional liposuction effectively corrects all grades of gynecomastia. This combination has little morbidity, requires no skin excision, and leads to uniformly good esthetic results.