Treatment strategy refinement and long-term outcome assessment based on the magnetic resonance imaging features of gynecomastia
10.3760/cma.j.issn.1671-0290.2024.03.002
- VernacularTitle:男性乳房发育症核磁共振特征以及改良手术策略和长期效果研究
- Author:
Zenan XIA
1
;
Xinran ZHANG
;
Yuanbo KANG
;
Wenchao ZHANG
;
Nanze YU
;
Zhifei LIU
;
Lin ZHU
Author Information
1. 中国医学科学院 北京协和医院整形美容外科，北京 100032
- Keywords:
Gynecomastia;
Magnetic resonance imaging;
Liposuction;
Small incision;
Minimal invasiveness
- From:
Chinese Journal of Medical Aesthetics and Cosmetology
2024;30(3):202-207
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To improve and optimize the modified surgical strategies for patents with Simon Ⅰ and Simon Ⅱ type of gynecomastia, based on their magnetic resonance imaging (MRI) features.Methods:Clinical data of 190 patients aged 12 to 56 years (mean age 26.7±8.6) with gynecomastia who underwent modified surgeries in the Department of Plastic Surgery of Peking Union Medical College Hospital from January 2017 to January 2023 were retrospectively analyzed. The study measured breast MRI images of 44 male patients to calculate the area ratio of the glands on the transverse plane via nipple. This provided insight into the physiological structure and the tissue distribution of gynecomastia for improving the modified surgical strategies. All 190 patients were treated with enhanced liposuction and " Pull-Through and Bottom-Up" techniques. The duration of operation, amount of liposuction and amount of glandular resection, postoperative complications were recorded, and postoperative satisfaction was investigated by questionnaire surveys.Results:MRI images of the 87-side male breast showed that the average area ratio of the glands on the transverse plane via nipple was (10.9±12.5) %. The most prevalent subtype of gynecomastia was branch pattern, accounting for 46.0%. The median surgical duration of 190 patients was 95 (65-210) minutes, the median liposuction volume was 300 (50-1 400) ml, and the median glandular removal was 19.9 (1.5-157.0) g. Eighty-eight patients (46.3%) went through followed up for more than 6 months post-posterative with an overall satisfaction score of 4.68±0.53. Postoperative complications occurred in 19 sides (5.1%), and the reoperation rate was 1.3%.Conclusions:The MRI imaging of gynecomastia shows that the component of patients′ breasts are mainly fat, with a small amount of glandular tissue and the dominant subtype is branch pattern. Enhanced liposuction combined with " Pull-Through and Bottom-Up" stab incision technique can be an effective treatment for Simon grades Ⅰ and Ⅱ gynecomastia. The method results in high patient satisfaction with fewer postoperative complications.
