Skip to main content
Top
Published in: Aesthetic Plastic Surgery 1/2022

01-02-2022 | Seroma | Review

Liposuction Assisted Gynecomastia Surgery With Minimal Periareolar Incision: a Systematic Review

Authors: Theddeus Octavianus Hari Prasetyono, Angelica Gracia Budhipramono, Illona Andromeda

Published in: Aesthetic Plastic Surgery | Issue 1/2022

Login to get access

Abstract

Background

This study aims to analyse the quality of studies and revisit the liposuction assisted gynecomastia surgery performed through minimal incision.

Methods

A systematic review, based on the literature in the PubMed, Scopus, Science Direct, and Cochrane, to the treatment of Simon’s grade I and II gynecomastia was conducted using keywords “gynecomastia” AND “liposuction.” Study appraisal was performed using MINORS to assess the methodological quality of the paper.

Results

There were 18 out of 415 studies eligible to review. A total of 244 out of 1628 patients with the average age of 23.13 years. Liposuction facilitated the easy handling to remove the breast tissue via small incisional design; showed consistent improved quality of life in terms of satisfaction after surgery. However, the measuring method of satisfaction rate varied, resulting in difficulties to interpret the results. Complication rates were inconsistent throughout the studies, ranging from 0.06 to 26.67%. Reoperation rate of liposuction-assisted surgery is between 0.6 and 25%. There are only two studies of a total 25 patients that are considered as good in quality. The two studies, which discuss laser-assisted liposuction technique, show minor complication of seroma in two patients. While one study shows high patient’s satisfaction rate; both studies indicate high surgeon’s satisfaction rate.

Conclusion

Small incisional design for breast parenchymal removal in gynecomastia assisted by liposuction showed a good technical approach for consistent improvement in quality of life. However, only 2 studies reported good quality methods of non-randomized case series urging for a better quality of studies in the future.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literature
1.
go back to reference Fagerlund A, Lewin R, Rufolo G, Elander A, Santanelli Di Pompeo F, Selvaggi G (2015) Gynecomastia: a systematic review. J Plast Surg Hand Surg 49:311–318CrossRef Fagerlund A, Lewin R, Rufolo G, Elander A, Santanelli Di Pompeo F, Selvaggi G (2015) Gynecomastia: a systematic review. J Plast Surg Hand Surg 49:311–318CrossRef
2.
go back to reference Zugang K, Hassan A (2016) Combined approach for gynecomastia. GMS Interdiscip Plast Reconstr Surg 5:1–12 Zugang K, Hassan A (2016) Combined approach for gynecomastia. GMS Interdiscip Plast Reconstr Surg 5:1–12
3.
go back to reference Jose RM, Thomas S (2011) Gynaecomastia correction—the role of power-assisted liposuction. Eur J Plast Surg 34:187–191CrossRef Jose RM, Thomas S (2011) Gynaecomastia correction—the role of power-assisted liposuction. Eur J Plast Surg 34:187–191CrossRef
4.
go back to reference Mohan A, Abbas Khan MA, Srinivasan K, Roberts J (2014) Gynaecomastia correction: a review of our experience. Indian J Plast Surg 47:56–60CrossRef Mohan A, Abbas Khan MA, Srinivasan K, Roberts J (2014) Gynaecomastia correction: a review of our experience. Indian J Plast Surg 47:56–60CrossRef
5.
go back to reference Polat S, Cuhaci N, Evranos B, Ersoy R, Cakir B (2014) Gynecomastia: clinical evaluation and management. Indian J Endocrinol Metab 18:150–159CrossRef Polat S, Cuhaci N, Evranos B, Ersoy R, Cakir B (2014) Gynecomastia: clinical evaluation and management. Indian J Endocrinol Metab 18:150–159CrossRef
7.
go back to reference Hoşnuter M (2014) An ameliorated approach for sharp resection in gynecomastia surgery. Indian J Surg 76:419–424CrossRef Hoşnuter M (2014) An ameliorated approach for sharp resection in gynecomastia surgery. Indian J Surg 76:419–424CrossRef
9.
go back to reference Polit DF, Beck CT (2004) Analyzing quantitative data: descriptive statistics. In: Polit DF, Beck CT (eds) Nursing research: principles and methods, 7th edn. Lippincott-Raven, Philadelphia, pp 451–476 Polit DF, Beck CT (2004) Analyzing quantitative data: descriptive statistics. In: Polit DF, Beck CT (eds) Nursing research: principles and methods, 7th edn. Lippincott-Raven, Philadelphia, pp 451–476
11.
go back to reference Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J (2003) Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ANZ J Surg 73:712–716CrossRef Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J (2003) Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ANZ J Surg 73:712–716CrossRef
12.
go back to reference Cigna E, Tarallo M, Fino P, De Santo L, Scuderi N (2011) Surgical correction of gynecomastia in thin patients. Aesthetic Plast Surg 35:439–445CrossRef Cigna E, Tarallo M, Fino P, De Santo L, Scuderi N (2011) Surgical correction of gynecomastia in thin patients. Aesthetic Plast Surg 35:439–445CrossRef
13.
go back to reference Choi BS, Lee SR, Byun GY, Hwang SB, Koo BH (2017) The characteristics and short-term surgical outcomes of adolescent gynecomastia. Aesthetic Plast Surg 41:1011–1021CrossRef Choi BS, Lee SR, Byun GY, Hwang SB, Koo BH (2017) The characteristics and short-term surgical outcomes of adolescent gynecomastia. Aesthetic Plast Surg 41:1011–1021CrossRef
14.
go back to reference Sim N, Tan G, Tan B-K, Goh T (2020) Review of the microdebrider excision and liposuction technique (MELT) for the treatment of gynecomastia. J Plast Reconstr Aesthetic Surg 73:303–312CrossRef Sim N, Tan G, Tan B-K, Goh T (2020) Review of the microdebrider excision and liposuction technique (MELT) for the treatment of gynecomastia. J Plast Reconstr Aesthetic Surg 73:303–312CrossRef
15.
go back to reference Abdelrahman I, Steinvall I, Mossaad B, Sjoberg F, Elmasry M (2018) Evaluation of glandular liposculpture as a single treatment for grades I and II gynaecomastia. Aesthetic Plast Surg 42:1222–1230CrossRef Abdelrahman I, Steinvall I, Mossaad B, Sjoberg F, Elmasry M (2018) Evaluation of glandular liposculpture as a single treatment for grades I and II gynaecomastia. Aesthetic Plast Surg 42:1222–1230CrossRef
16.
go back to reference Lee SR, Lee SG, Byun GY, Kim MJ, Koo BH (2018) Clinical characteristics of asymmetric bilateral gynecomastia: suggestion of desirable surgical method based on a single-institution experience. Aesthetic Plast Surg 42:708–715CrossRef Lee SR, Lee SG, Byun GY, Kim MJ, Koo BH (2018) Clinical characteristics of asymmetric bilateral gynecomastia: suggestion of desirable surgical method based on a single-institution experience. Aesthetic Plast Surg 42:708–715CrossRef
17.
go back to reference Tarallo M, Di Taranto G, Fallico N, Ribuffo D (2019) The round-the-clock technique for correction of gynecomastia. Arch Plast Surg 46:221–227CrossRef Tarallo M, Di Taranto G, Fallico N, Ribuffo D (2019) The round-the-clock technique for correction of gynecomastia. Arch Plast Surg 46:221–227CrossRef
18.
go back to reference Taheri AR, Farahvash MR, Fathi HR, Ghanbarzadeh K, Faridniya B (2016) The satisfaction rate among patients and surgeons after periareolar surgical approach to gynecomastia along with liposuction. World J Plast Surg 5:287–292PubMedPubMedCentral Taheri AR, Farahvash MR, Fathi HR, Ghanbarzadeh K, Faridniya B (2016) The satisfaction rate among patients and surgeons after periareolar surgical approach to gynecomastia along with liposuction. World J Plast Surg 5:287–292PubMedPubMedCentral
19.
go back to reference Khalil AA, Ibrahim A, Afifi AM (2017) No-drain single incision liposuction pull-through technique for gynecomastia. Aesthetic Plast Surg 41:298–303CrossRef Khalil AA, Ibrahim A, Afifi AM (2017) No-drain single incision liposuction pull-through technique for gynecomastia. Aesthetic Plast Surg 41:298–303CrossRef
20.
go back to reference Kim DH, Byun IH, Lee WJ, Rah DK, Kim JY, Lee DW (2016) Surgical management of gynecomastia: subcutaneous mastectomy and liposuction. Aesthetic Plast Surg 40:877–884CrossRef Kim DH, Byun IH, Lee WJ, Rah DK, Kim JY, Lee DW (2016) Surgical management of gynecomastia: subcutaneous mastectomy and liposuction. Aesthetic Plast Surg 40:877–884CrossRef
21.
go back to reference Cardenas-Camarena L, Dorado C, Guerrero MT, Nava R (2017) Surgical masculinization of the breast: clinical classification and surgical procedures. Aesthetic Plast Surg 41:507–516CrossRef Cardenas-Camarena L, Dorado C, Guerrero MT, Nava R (2017) Surgical masculinization of the breast: clinical classification and surgical procedures. Aesthetic Plast Surg 41:507–516CrossRef
22.
go back to reference Trelles MA, Mordon SR, Bonanad E, Moreno Moraga J, Heckmann A, Unglaub F et al (2013) Laser-assisted lipolysis in the treatment of gynecomastia: a prospective study in 28 patients. Lasers Med Sci 28:375–382CrossRef Trelles MA, Mordon SR, Bonanad E, Moreno Moraga J, Heckmann A, Unglaub F et al (2013) Laser-assisted lipolysis in the treatment of gynecomastia: a prospective study in 28 patients. Lasers Med Sci 28:375–382CrossRef
24.
go back to reference Lee JH, Kim IK, Kim TG, Kim YH (2012) Surgical correction of gynecomastia with minimal scarring. Aesthetic Plast Surg 36:1302–1306CrossRef Lee JH, Kim IK, Kim TG, Kim YH (2012) Surgical correction of gynecomastia with minimal scarring. Aesthetic Plast Surg 36:1302–1306CrossRef
25.
go back to reference Sönmez Ergün S, Kayan RB, Güleş ME, Kuzu İM (2017) Effects of laser-assisted lipolysis on nipple-areola complex. J Cosmet Laser Ther 19:215–218CrossRef Sönmez Ergün S, Kayan RB, Güleş ME, Kuzu İM (2017) Effects of laser-assisted lipolysis on nipple-areola complex. J Cosmet Laser Ther 19:215–218CrossRef
26.
go back to reference Gökkaya A, Görgü M, Acuner B (2020) Gynecomastia treatment with liposuction: clinical experience. Duzce Med J 22:17–22 Gökkaya A, Görgü M, Acuner B (2020) Gynecomastia treatment with liposuction: clinical experience. Duzce Med J 22:17–22
27.
go back to reference Xu B, Mu D, Yang Y, Liu T (2020) Endoscopic axillary approach improves patient satisfaction of gynecomastia subcutaneous mastectomy: a cross-sectional study using the BODY-Q chest module. Aesthetic Plast Surg 44:2011–2020CrossRef Xu B, Mu D, Yang Y, Liu T (2020) Endoscopic axillary approach improves patient satisfaction of gynecomastia subcutaneous mastectomy: a cross-sectional study using the BODY-Q chest module. Aesthetic Plast Surg 44:2011–2020CrossRef
28.
go back to reference Boonstra AM, Schiphorst Preuper HR, Balk GA, Stewart RE (2014) Cut-off points for mild, moderate, and severe pain on the visual analogue scale for pain in patients with chronic musculoskeletal pain. Pain 155:2545–2550CrossRef Boonstra AM, Schiphorst Preuper HR, Balk GA, Stewart RE (2014) Cut-off points for mild, moderate, and severe pain on the visual analogue scale for pain in patients with chronic musculoskeletal pain. Pain 155:2545–2550CrossRef
29.
go back to reference Voutilainen A, Pitkäaho T, Kvist T, Vehviläinen-Julkunen K (2016) How to ask about patient satisfaction? The visual analogue scale is less vulnerable to confounding factors and ceiling effect than a symmetric Likert scale. J Adv Nurs 72:946–597CrossRef Voutilainen A, Pitkäaho T, Kvist T, Vehviläinen-Julkunen K (2016) How to ask about patient satisfaction? The visual analogue scale is less vulnerable to confounding factors and ceiling effect than a symmetric Likert scale. J Adv Nurs 72:946–597CrossRef
30.
go back to reference Bellini E, Grieco MP, Raposio E (2017) A journey through liposuction and liposculture: review. Ann Med Surg 24:53–60CrossRef Bellini E, Grieco MP, Raposio E (2017) A journey through liposuction and liposculture: review. Ann Med Surg 24:53–60CrossRef
31.
go back to reference Samdal F, Amland PF, Bugge JF (1994) Blood loss during liposuction using the tumescent technique. Aesthetic Plast Surg 18:157–160CrossRef Samdal F, Amland PF, Bugge JF (1994) Blood loss during liposuction using the tumescent technique. Aesthetic Plast Surg 18:157–160CrossRef
32.
go back to reference Stephan PJ, Dauwe P, Kenkel J (2018) Liposuction: A comprehensive review of techniques and safety. In: Rubin JP, Neligan PC (eds) Plastic surgery, vol 2. Aesthetic surgery. Elsevier, Seattle, pp 545–567 Stephan PJ, Dauwe P, Kenkel J (2018) Liposuction: A comprehensive review of techniques and safety. In: Rubin JP, Neligan PC (eds) Plastic surgery, vol 2. Aesthetic surgery. Elsevier, Seattle, pp 545–567
Metadata
Title
Liposuction Assisted Gynecomastia Surgery With Minimal Periareolar Incision: a Systematic Review
Authors
Theddeus Octavianus Hari Prasetyono
Angelica Gracia Budhipramono
Illona Andromeda
Publication date
01-02-2022
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 1/2022
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-021-02520-z

Other articles of this Issue 1/2022

Aesthetic Plastic Surgery 1/2022 Go to the issue