Objective To explore the surgical application and cosmetic effect of minimally invasive small excision supplement with liposuction in the treatment of gynecomastia.Methods 7 patients were diagnosed as gynecomastia.All patients were given minimally invasive excision.The procedure was carried out by minimally invasive excision on areola plus liposuction subcutaneous glandular.Following the procedure,fat lysate was infused into adipose layer surrounding breast hypertrophy region.A 1-2cm areola incision was made.Fat tissue was removed by using negative pressure aspirator suction.Finally,the whole glands and residual fat tissue were cleared away.Following the surgery,subcutaneous suture and skin adhesive bonding,and wound compression bandage were applied to the area with surgical incision.Results All patients achieved grade Ⅰ gynecomastia with minimally invasive small excision.Their chests had natural,smooth and symmetrical appearance.There were no uneven feeling and obvious incision scar,also no necrosis in the nipple and areola.The average operation time was 60 min for unilateral surgery (40-90min).The average bleeding was 40mL (30-60mL).One patient had local hematoma,but got better following continued compression bandage.One patient was observed numbness in nipple areola.But it disappeared after 1-3 months follow-up.Conclusion Our experience with minimally invasive breast surgery for gynaecomastia continues to give excellent results of cosmesis with minimum morbidity.

Objective To evaluate the effects and cosmetic results of total removal of the glands for male gynecomastia . Methods A total of 13 male patients with gynaecomastia were operated by using the method of keyhole-style total removal of the glands from March 2012 to March 2013.The fat lysate was injected into the subcutaneous area of the breast enlargement .Then an incision about 1.0 cm in length was made by the side of areola , through which a vacuum aspiration was carried out to suck the fat tissues.Also, the hypertrophical breast tissues were excised gradually .Finally, the incision was closed with medical biological adhesive or absorbable suture . Results The time of unilateral operation was 40-100 min ( average , 70 min) .The amount of blood loss was 20-50 ml (average, 30 ml).Subcutaneous effusion occurred in 2 cases (accompanying local hematoma in 1 case), which was cured by repeated aspiration for 3 days.The postoperative hospitalization was 2-5 days (mean, 2.8 days).All the patients were cured with incision healed by first intention and no obvious scars left .There was no necrosis on the nipple or areola .The breast curve was flat and natural .A total of 8 cases were followed up for 3 months, with satisfactory appearance .Three patients felt numbness of nipples and areola of breast after surgery and the symptom disappeared 3 months later . Conclusion Keyhole-style total removal of the glands for the male ynaecomastia has advantages of easy operation ,safety,and good cosmetic results .