Abstract
Background
Gynecomastia is a common disease in male patients that is characterized by benign breast enlargement. Gynecomastia may involve fibroglandular tissue (FGT), supramammary fat tissue, and retromammary fat tissue (RMFT). Gynecomastia is usually treated surgically; however, some patients undergo reoperation because of dissatisfaction with the results of the first operation. This study aimed to analyze the breast conditions requiring reoperation and to identify factors requiring attention during the first gynecomastia surgery.
Methods
We retrospectively evaluated 98 patients who underwent reoperation because of unsatisfactory esthetic outcomes from January 2014 to April 2020. According to the reasons for dissatisfaction, patients were divided into undercorrection and overcorrection groups. Patients with remnant breast tissue were assigned to the undercorrection group, while those in whom excess breast tissue was removed and was assigned to the overcorrection group.
Results
The undercorrection and overcorrection groups comprised 81 and 17 patients, respectively. In the undercorrection group, 49 (60.5%) patients had residual FGT and fat tissue necessitating simultaneous FGT excision and liposuction, while 32 (39.5%) patients had no residual FGT and were treated with liposuction only. In the overcorrection group, 13 (76.5%) patients had undergone excessive removal of RMFT at the inferolateral aspect of the pectoralis major muscle margin and were treated by autologous fat grafting.
Conclusions
The most common cause of undercorrection was incomplete FGT removal, and the most common cause of overcorrection was excessive RMFT removal. Complete FGT excision and proper RMFT preservation can reduce the reoperation rate after gynecomastia surgery.
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Acknowledgements
The authors thank Beom Seok Oh and Young Hyun Lee from the Research Center of Damsoyu Hospital for assisting with the statistical analysis and organizing the data in the manuscript. We thank Hyejin Park for editing of this manuscript. We thank Kelly Zammit, BVSc, and Jane Charbonneau, DVM, from Edanz Group (https://en-author-services.edanz.com/ac), for editing a draft of this manuscript.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of our institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Institutional Review Board of Damsoyu Hospital (DSY-2020-005).
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Lee, S.R., Lee, S.G. Reoperation Because of Dissatisfaction with the Aesthetic Results of Gynecomastia Surgery: Technical Considerations. Aesth Plast Surg 45, 1444–1450 (2021). https://doi.org/10.1007/s00266-020-02124-z
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DOI: https://doi.org/10.1007/s00266-020-02124-z