Effective minimally invasive strategy for mixed-type gynecomastia using vacuum-assisted mastectomy and power-assisted liposuction.

Abstract

Mixed-type gynecomastia is a benign male breast condition characterized by the proliferation of glandular and adipose tissues. Conventional open surgery has been the main approach for treating gynecomastia. However, this method has been associated with complications, including breast deformity, noticeable scar, nipple necrosis, and hypoesthesia. In contrast, vacuum-assisted biopsy systems and liposuction have demonstrated significant advantages in minimally invasive breast surgery. Our study aimed to investigate the effectiveness of combining vacuum-assisted mastectomy with power-assisted liposuction (VAM+PAL) for patients with mixed-type gynecomastia compared to conventional open surgery. Sixty patients with mixed-type gynecomastia, treated between January 2019 and June 2023, were included in this study. VAM+PAL was performed on 30 patients (59 breasts), and open excision with periareolar approach was performed on 30 patients (59 breasts). The efficacy, complications, outcomes, scar cosmesis, and patient satisfaction were assessed. Compared to open excision group for gynecomastia, the VAM+PAL group demonstrated a substantial reduction in incision size (4.47 ± 1.21 cm vs. 0.97 ± 0.74 cm, p < 0.001) and lower scores of Vancouver scar scale (3.23 ± 2.27 vs. 1.10 ± 1.47, p < 0.001). No drainage tubes were required for postoperative hematoma/seroma prevention. The patients in the VAM+PAL group had significantly lower complication rates (18.64% vs. 3.39%, p = 0.008), particularly in bruise and hypoesthesia. All VAM+PAL patients reported superior satisfaction with the outcomes in breasts and nipples. The combination of vacuum-assisted mastectomy and power-assisted liposuction can be used as an efficient minimally invasive method to treat mixed-type gynecomastia with acceptable complications, superior scar cosmesis, and satisfying outcomes.