The combined surgical treatment of High-Grade Gynecomastia (grad IIb-III simons)

Gynecomastia is the proliferation of the glandular tissue of the male breast with a prevalence of 40 to 56 percent of men. Its etiology is varied. In this study، we performed a combined surgical method using liposuction، resection of the remaining tissue (pull through)، and circumareolar skin excision and presented the results. This was a prospective study carried out from 1388 to 1391 on 15 male patients (30 breasts) with gynecomastia. Patient data including grade، technique، and operations were evaluated. The mean age was 22 years، (min=16، max=35). Resection of the remaining tissue was required in 8 patients. The mean amount of resection was 20 gr. Of these، 6 patients were grade IIb and 2 grade III Simons. In 7 cases، no glandular tissue was palpated following liposuction and no incision was required for excision of tissue. Among these، 4 patients were grade IIb and 3 grade III Simons. We recommend liposuction with or without excision of remaining tissue for grade I and II Simons gynecomastia and the combined liposuction، pull through، periareolar skin excision technique for grade III cases.