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Gynecomastia: CCF modified reduced scar technique
J Roberto Ramirez
David E. Estrada
Gaby Doumit
Cleveland Clinic
2012-02-15
Presenter: J Roberto Ramirez
Affidavit:
The abstract presented is a modification that has been employed at our insitution to try to reduce the surgical scar, even in cases of high grade gynecomastia.
Director Name: Steven Bernard
Author Category: Other Specialty Resident
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
How does this presentation meet the established conference educational objectives?
We decribe our technique and will be able to analyse the different approches and expose the advantages and disavantages of our techniques.
How will your presentation be used by practicing physicians in the audience?
This presentation will show that our technique can be used even in cases of high grade gynecomastia while reducing the scar size.
Gynecomastia is an enlargement of the male breast due to proliferation of the gland. Most cases of idiopathic gynecomastia are in young patients. Interfering with self esteem and social interaction. Surgery is indicated when the condition fails to regress or if it is causing sufficient embarrassment to interfere with the social life.
Our technique: A 25 to 35 mm diameter nipple areola complex (NAC) is outlined around the nipple. An incision is carried from 3 to the 9 o'clock along the marked upper half of the NAC. Subcutaneous glandular excision is then completed. A second circumareolar circle is outlined 1-3 cm from the outlined NAC representing the skin to be excised along the superior half and deepithelialized along the inferior half of NAC. A deep intradermal circumareolar pursestring suture is carried for skin closure.
In total we operated on five (10 breasts) male patients. Patient's age ranged from 14 to 25 years (Median 16 years). Breast tissue resection ranged from (91g to 320 g). The mean was 208 g. There were one seroma post-operatively. Mean follow up was 7 months (range 6 – 12 months). No patient underwent revision.
High grade gynecomastia (Simons's grade III or Rohrich IV) has been traditionally approached with an inverted T incisions or with a vertical incision. Those surgical techniques has the major disadvantage of leaving an unsuitably scar. In all the patients were left with no vertical or inframammary scars and the contour of the chest wall was satisfactory in all patients
