A New Modified Postero-Inferior Technique in Management of Grade III Gynecomastia

Abstract

Abstract:Backgrounds: Many surgical techniques have been described for management of grade III gynecomastia. Nipple–areola complex (NAC) free transfer, inferior and superior pedicle techniques have been published in the literatures for treatment of grade III gynecomastia. In order to reduce the excess skin, all theses techniques leave acceptable scars. Original postero-inferior technique was described to improve the aesthetic outcome with preserving the neurovascular pedicle of the areola. This technique maintains the sensitivity and vitality of the new areola, but postoperative rates of breast contour and NAC were still not satisfactory. In this study, we described a new modified postero-inferior technique and compared its functional and aesthetic outcomes to that of the original technique. Aim of this study: is to compare the functional and aesthetic outcomes as well as patients’ satisfaction of the original and modified postero-inferior pedicle techniques in patients with grade III gynecomastia.Patients and Methods: 12 adult patients suffering from grade III gynecomastia were included in this cohort prospective study. Patients were treated surgically by modified postero-inferior technique. Post operative aesthetic and functional outcomes, as well as patients’ satisfaction were evaluated by patients’ questionnaires and compared to that of the original technique.Results: In comparison to the original technique, aesthetic outcome of modified technique showed more patient satisfaction as regards chest contour (Q1) and NAC rating (Q2) with the same rate of patients’ satisfaction as regards functional outcomes (nipple sensitivity and parathesia) also both techniques showed postoperative intact vascularity of the new NAC. Rate of complications decreased from 33% in the original technique to 16.7% in the modified technique with 100% postoperative rate of NAC symmetry. Conclusion: The new modified postero-inferior technique improves the postoperative aesthetic outcomes as well as it preserves the same functional outcomes, if compared with that of the original technique.