Comparative Study between Circum-areolar Skin Reduction and Standard Long Scar Techniques for Treatment of Severe Degrees of Gynaecomastia after Massive Weight Loss

Selim, Ismael Mahmoud; Hamza, Fawzy Ahmad; Meky, Mustafa Sayed Ahmed

doi:10.21608/ejhm.2019.61474

Comparative Study between Circum-areolar Skin Reduction and Standard Long Scar Techniques for Treatment of Severe Degrees of Gynaecomastia after Massive Weight Loss

Document Type : Original Article

Authors

Plastic and Burn surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

10.21608/ejhm.2019.61474

Abstract

Background: Reshaping of the male chest following massive weight loss is challenging and there are many techniques for its management. Aim: This study was to compare circum-areolar skin reduction for the treatment of severe gynaecomastia in massive weight loss patients with other standard long scar techniques. Patients and methods: Patients with massive weight loss whom their redundant and ptosed breast and patients whom their weight was stable for at least 6 months before surgical intervention for the treatment of gynaecomastia. Those patients were included in the study. Patients were subjected to either circum-areolar or other long standard scar techniques in 2 equal groups. Patients were evaluated subjectively and objectively. Results: As for patient’s satisfaction, there was statistically significant higher satisfaction (p=0.039) among patients submitted to circum-areolar approach regarding the overall chest contour (80% vs 50%) and nipple-areola complex aesthetics (90% vs 60%). Objective assessment showed better outcome for circum-areolar scar in cases of moderate skin laxity and minimal glandular tissue, while other long standard scars could be appropriate with patients having massive skin laxity and marked glandular atrophy. Conclusion: Circum-areolar skin reduction technique is an effective, safe, and promising approach in the management of gynaecomastia after massive weight loss, which is an accomplished advancement relative to other standard long scar techniques. Circum-areolar skin reduction technique is the best for the patients with moderate skin redundancy where it preserved glandular tissue and no presence of side or back rolls. While, long scar techniques are favorable in patients with severe skin redundancy and atrophied glandular tissue with side or back rolls.

Keywords