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CC BY-NC-ND 4.0 · Indian J Plast Surg 2024; 57(06): 455-460
DOI: 10.1055/s-0044-1789005
Original Article

Long-Term Outcome of Surgery for Grade 4 Gynecomastia: A Single-Center Experience

Authors

  • Aakanksha Goel 

    1   Department of Aesthetic Surgery, Divine Aesthetic Surgery, New Delhi, India

  • Sudhanshu Punia

    1   Department of Aesthetic Surgery, Divine Aesthetic Surgery, New Delhi, India

  • Amit Gupta

    1   Department of Aesthetic Surgery, Divine Aesthetic Surgery, New Delhi, India

Funding None.
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Abstract

Background Gynecomastia results in a feminine appearance of the male chest, leading to social embarrassment and loss of self-esteem in the afflicted males. Grade 4 gynecomastia is expected to have less than perfect results with liposuction and gland excision alone. This study was done to assess the long-term outcome of this surgery for grade 4 gynecomastia.

Materials and Methods From January 2021 to December 2022, 81 patients with grade 4 gynecomastia were treated by us. All the patients underwent vibration amplification of sound energy at resonance (VASER) and suction-assisted liposuction of the chest and side rolls with excision of the gland with crescentic lift in the cases with ptosis. A retrospective study was done to analyze the long-term surgical outcomes in these patients by review of clinical records.

Results Symmetry was achieved in 37/39 patients with grade 4a gynecomastia but only in 33/42 patients with grade 4b gynecomastia. The inframammary fold disappeared in 35/39 patients with grade 4a gynecomastia but only in 25/42 of grade 4b gynecomastia patients. Ptosis was corrected in 35/42 grade 4b gynecomastia patients. The mean follow-up was 15 months (range: 12–24 months). Only seven patients desired a second stage to correct the remaining deformity.

Conclusion Liposuction with gland removal alone in grade 4a gynecomastia and with liposuction with crescentic nipple–areola complex (NAC) lift in patients of grade 4b gynecomastia give satisfactory results in patients with massively enlarged breasts. While grade 4a gynecomastia has overall better results and lesser complications as compared with grade 4b gynecomastia, the latter also has acceptable outcomes. Realistic prognosis needs to be explained to the patient preoperatively.

Keywords

gynecomastia - liposuction - obesity - severe grade

Note

This paper was presented by Dr. Aakanksha Goel at APSICON 2023, Indore on December 30, 2023.


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Publication History

Article published online:
03 September 2024

© 2024. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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