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"Single wing" limited scar technique for the management of ptosis grade 3 or greater in patients with gynecomastia.

Julio A. Clavijo-Alvarez MD, PhD;Guy M. Stofman MD. FACS
University of Pittsburgh Medical Center

Presenter: Julio A. Clavijo-Alvarez


Director Name: Joseph Losee

Author Category: Chief Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics

How does this presentation meet the established conference educational objectives?
This is a novel technique that improves the scar in patient undergoing gynecomastia treatment

How will your presentation be used by practicing physicians in the audience?
In their treatment of gynecomastia patients

Gynecomastia is a common condition among males. The estimated incidence is around 40% in autopsy series and up to 65% of adolescent males. Current surgical management of moderate to severe hypertrophy with ptosis includes liposuction or surgical excision. Disadvantages of liposuction include the lack of treatment of the redundant skin envelope. On the other hand the current surgical techniques entail a trade of scars for form. Here we present a novel limited scar technique that accomplishes the treatment of redundant skin envelopes at the same time that decreases the size of the scar.
The "single wing" was performed in 5 consecutive patients from 2005 to 2010. The ideal candidates are male patients with grade II or III gynecomastia with excess skin redundancy.

The markings combines a Delta wing component asymmetrically center from the nipple. Once the incisions are made a rotation and advancement allows repositioning the nipple to the ideal location, as well as limiting the size of the medial scar to be included within the nipple. (figure 1)
The contour of the ptotic breast was achieved, while reducing the length of the scars with traditional techniques. There were no minor nor moderate wound healing problems. Scars were well concealed around the nipple and the lower aspect of the lateral scar.
The "single wing" limited scar technique modification satisfactorily corrects moderate and severe gynecomastia by addressing the redundant skin envelope at the same time that limits the length of the scar.

Ohio,Pennsylvania,West Virginia,Indiana,Kentucky,Pennsylvania American Society of Plastic Surgeons

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