Abstract
BackgroundGynecomastia is defined as a benign glandular proliferation of the male breast tissue causing enlargement of the breast and a feminine appearance. Gynecomastia is usually treated surgically in some patients by different techniques.Aim of the studyis to allow ample excess during excision and to remove excess skin to allow for better cosmetic results using “modified Benelli technique” and to obtain good breast shape with better nipple areola complex position without any breast tension.Type of the studyRandomised controlled trial study.Patients and methodsThe study included 150 patients with gynecomastia (Grade II and III) for the period between January 2010 and January 2016 who attended private hospitals and Al-Kindy Teaching Hospital. The patients were divided into two groups according to the operative techniques used. Group A included 75 patients treated surgically with subcutaneous mastectomy using periareolar incision. Group B; included the other 75 patients who were managed by “modified Benelli technique".ResultsThe subcutaneous mastectomy using “modified Benelli technique” showed a significantly lower operating time due to ample access for excision of breast tissue. Excision of excess skin allowed the areola to retain a cosmetically more acceptable position. There was a lot of pleating of the skin compared to the other technique using the periareolar incision.ConclusionsThis technique namely the “modified Benilli technique” provides a relatively simple method with an aesthetically good outcome to treat gynecomastia with a low rate of complications and recurrences.
Highlights
Gynecomastia is a generalized enlargement of male breast tissues
Most cases are idiopathic especially during puberty and the pathophysiological mechanism involves various diseases including hepatic disease, renal diseases, and endocrine diseases [1].Gynecomastia has an overall incidence of 32–40%, with a prevalence reported as high as 65% in elderly males [2].True gynecomastia is characterized by hypertrophy of the stroma and glandular tissue, while pesudogynecomastia results from obesity and adipose tissue hypertrophy [3,4]
These methods were associated with many complications like contour irregularity of the breast, hematoma, seroma, numbness, necrosis, breast asymmetry, and cosmetic non satisfaction [11].According to the stages of the gynecomastia and the cosmetic preference many types of incisions were used to provide optimal results [12].Regarding females’ cosmetic operation for the breast, “around the Block” incision was used by Benelli for ptosis of the breast and returning the nipple areola complex to a more acceptable position
Summary
Gynecomastia is a generalized enlargement of male breast tissues. Most cases are idiopathic especially during puberty and the pathophysiological mechanism involves various diseases including hepatic disease, renal diseases, and endocrine diseases [1].Gynecomastia has an overall incidence of 32–40%, with a prevalence reported as high as 65% in elderly males [2].True gynecomastia is characterized by hypertrophy of the stroma and glandular tissue, while pesudogynecomastia results from obesity and adipose tissue hypertrophy [3,4]. There are a lot of other options adays for treatment like subcutaneous mastectomy that involves direct resection of the glandular tissue using a peri-areolar or trans-areolar approach with or without liposuction [10] These methods were associated with many complications like contour irregularity of the breast, hematoma, seroma, numbness, necrosis, breast asymmetry, and cosmetic non satisfaction [11].According to the stages of the gynecomastia and the cosmetic preference many types of incisions were used to provide optimal results [12].Regarding females’ cosmetic operation for the breast, “around the Block” incision was used by Benelli for ptosis of the breast and returning the nipple areola complex to a more acceptable position. Conclusions: This technique namely the “modified Benilli technique” provides a relatively simple method with an aesthetically good outcome to treat gynecomastia with a low rate of complications and recurrences
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