Endoscopic Subcutaneous Mastectomy for the Treatment of Gynecomastia
Breast Disease Center, Southwest Hospital, Third Military Medical University, Chongqing, China.Surgical laparoscopy, endoscopy & percutaneous techniques (Impact Factor: 1.14). 07/2009; 19(3):e85-90. DOI: 10.1097/SLE.0b013e3181a2fdbd
The aim of this study is to introduce the endoscopic subcutaneous mastectomy without skin excision as the standard surgical technique for grade IIB and III gynecomastia. Endoscopic subcutaneous mastectomy was performed successfully in 125 breasts of 65 patients with Simon's grade IIB and III gynecomastia. The volume of gland resected in the 125 breasts was 80 to 300 mL, with the mean of 146 mL. The operation time was 65 to 155 minutes, with the mean of 82 minutes. There were a few operative complications, including partial nipple necrosis in 2 cases and subcutaneous hydrops in 1 case; but no complete nipple necrosis, subcutaneous emphysema, postoperative active bleeding, local skin necrosis, or operation-side infection occurred. Satisfactory chest contour was gained in all cases without any abnormality, skin redundancy, or recurrence during the follow-up of 3 to 36 months. Endoscopic subcutaneous mastectomy is distinctive and practicable in manipulation as well as safe and can get esthetic effect. It is a new choice for the treatment of gynecomastia.
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ABSTRACT: Surgery has become the accepted standard for the majority of patients with gynecomastia to get rid of feminine-looking breast enlargement. Many surgical techniques have been proposed according to grade of gynecomastia. The sharp resection of glandular tissues is a keystone for most of them. However, technical difficulties in application and inexperience in mastectomy often lead to poor cosmetic outcomes. Over excision and saucer-like deformity, under resection, and asymmetries are most common ones among them. The author presents an ameliorated subcutaneous mastectomy method to facilitate the learning curve and to improve the esthetic results avoiding saucer-like deformity and other breast contour deformities. This method consists of an en bloc tissue dissection via superior periareolar incision and excision of fatty glandular tissue in suprafascial plan, with slicing and trimming procedure. It is possible to adjust the degree of tissue reduction during surgery; hence, it may be labeled as a “cut-as-you-go” technique. Between 2008 and 2012, 23 male patients were operated with this technique. Medical photographs and drawings were used to describe the technique. The operation resulted in smooth, symmetric breasts befitting to men in all 23 patients. No major complications were observed in any of the cases. None of the patients reported a discomfort in sensation of nipple–areolar complex. The presented technique provides high degree of patient satisfaction and excellent esthetic outcomes and is a promising choice in gynecomastia surgery with extremely low recurrence rates and easy learning curve.
Conference Paper: An introduction to the IEEE guide for current limiting fuse[Show abstract] [Hide abstract]
ABSTRACT: This paper is the introduction for a panel session that will present the details of a new guide for current limiting fuses, IEEE C37.48.1 (2002). It covers the reason the guide was needed and provides an overview of the guide. This panel will review the guide in detail, summarizing the key points of each section of the document.
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ABSTRACT: Surgical excision has been an effective treatment for gynaecomastia. Recently, there has been a shift from the open approach to minimally invasive techniques. In this report we describe our technique which includes endoscopic excision and/or liposuction of gynaecomastia via a single lateral chest wall incision. Between May 2007 and April 2010, a total of 12 gynaecomastia patients were treated with liposuction and/or endoscopic excision. Patients were divided into 3 groups: group I; liposuction only, group II; endoscopic excision plus liposuction and group III; endoscopic excision only. One 15 mm incision was made laterally at the anterior axillary line. A vacuum assisted liposuction removing the fatty tissue was performed. Then endoscopic excision of the remaining fibroglandular tissue was done under vision through the same incision. The parynchyma was then dissected into small pieces and pulled out. Group I had liposuction only (n = 4), group II had liposuction combined with endoscopic excision (n = 7) (58%) while group III had endoscopic excision only (n = 1). The mean operative time for liposuction and endoscopic excision was 58 min for each side. Mean hospital stay was 1.4 days. Postoperative complications included infection with abscess formation and one patient had seroma. Mean follow-up was 56 weeks. Eleven out of twelve patients (92%) were satisfied with their results. Long-term follow-up showed that results were stable over time, and no revisions were necessary. Endoscopic excision of gynaecomastia through a single lateral chest wall incision is a minimally invasive effective and safe technique for the management of gynaecomastia, with excellent aesthetic results and an acceptable complication rate.
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