Araştırma Makalesi
Yıl 2020,
Cilt: 22 Sayı: 1, 17 - 22, 30.04.2020
Öz
Amaç: Jinekomasti fizyolojik, patolojik veya ilaca bağlı nedenlerle erkeklerdeki normal meme dokusunun görünür hale gelecek kadar büyümesidir. Fizyolojik ve patolojik jinekomasti östrojen ile androjen metabolizmasındaki bozulmadan dolayı ortaya çıkmaktadır. İlaca bağlı jinekomasti ise yine bu hormonal metabolizmayı etkileyen hormonlar dışında farklı ilaç gruplarında da yan etki olarak görülebilmektedir. Jinekomasti tedavisinde özellikle erken dönemde medikal tedavi ve neden olabilecek ilaçların kesilmesi, daha ileri dönemlerde ise direkt eksizyon, endoskopik subkutan mastektomi, liposuction yöntemleri ile eksizyon gibi çeşitli yöntemlerle başarılı sonuçlar bildirilmiştir.
Gereç ve Yöntemler: Bu çalışmada Evre I, II ve III hastalarda 3 farklı planda 3 farklı kalınlıkta kanüller ile aspirasyon destekli ıslak liposuction (suction assisted wet liposuction) tekniği ile jinekomasti tedavi sonuçlarımızı sunmaktayız. Bu teknik ile kliniğimizde 2009 ile 2019 arasında 45 hasta opere edilmiştir. Tüm hastalar operasyon sonrasında komplikasyon oranlarının ve nihai estetik sonucun gözlemlenebilmesi için postoperatif dönemde en az 6 ay takip edilmiştir.
Bulgular: Bu çalışmada değerlendirilen 45 hastada komplikasyon oranı %6,7, operasyon başarı oranı %93,3 ve hasta memnuniyeti %91,1 idi. Jinekomasti tedavisinde başta liposuction olmak üzere diğer mevcut tedaviler gözden geçirilmiş ve çalışmamızdaki sonuçlar literatür eşliğinde değerlendirilmiştir.
Sonuç: Jinekomastinin cerrahi tedavisinde mevcut çok sayıda farklı yöntem bulunmaktadır. Bu çalışmada ıslak liposuction yöntemi ile jinekomasti tedavisinde Evre I, II ve III hasta grubunda başarılı sonuçlar elde edildiği ve hasta memnuniyetinin yüksek olduğu gösterilmiştir
Gereç ve Yöntemler: Bu çalışmada Evre I, II ve III hastalarda 3 farklı planda 3 farklı kalınlıkta kanüller ile aspirasyon destekli ıslak liposuction (suction assisted wet liposuction) tekniği ile jinekomasti tedavi sonuçlarımızı sunmaktayız. Bu teknik ile kliniğimizde 2009 ile 2019 arasında 45 hasta opere edilmiştir. Tüm hastalar operasyon sonrasında komplikasyon oranlarının ve nihai estetik sonucun gözlemlenebilmesi için postoperatif dönemde en az 6 ay takip edilmiştir.
Bulgular: Bu çalışmada değerlendirilen 45 hastada komplikasyon oranı %6,7, operasyon başarı oranı %93,3 ve hasta memnuniyeti %91,1 idi. Jinekomasti tedavisinde başta liposuction olmak üzere diğer mevcut tedaviler gözden geçirilmiş ve çalışmamızdaki sonuçlar literatür eşliğinde değerlendirilmiştir.
Sonuç: Jinekomastinin cerrahi tedavisinde mevcut çok sayıda farklı yöntem bulunmaktadır. Bu çalışmada ıslak liposuction yöntemi ile jinekomasti tedavisinde Evre I, II ve III hasta grubunda başarılı sonuçlar elde edildiği ve hasta memnuniyetinin yüksek olduğu gösterilmiştir
Anahtar Kelimeler
endokrin meme hastalıkları jinekomasti liposuction vücut şekillendirme
Kaynakça
- Blau M, Hazani R, Hekmat D. Anatomy of the gynecomastia tissue and its clinical significance. Plast Reconstr Surg Glob Open. 2016;4(8):e854.
- Soliman AT, De Sanctis V, Yassin M. Management of adolescent gynecomastia: an update. Acta Biomed. 2017;88(2):204-13.
- Kanakis GA, Nordkap L, Bang AK, Calogero AE, Bártfai G, Corona G, et al. EAA clinical practice guidelines-gynecomastia evaluation and management. Andrology. 2019;7(6):778-93.
- Rasko YM, Rosen C, Ngaage LM, AlFadil S, Elegbede A, Ihenatu C, et al. Surgical management of gynecomastia: a review of the current insurance coverage criteria. Plast Reconstr Surg. 2019;143(5):1361-8.
- Fagerlund A, Lewin R, Rufolo G, Elander A, Santanelli di Pompeo F, Selvaggi G. Gynecomastia: a systematic review. J Plast Surg Hand Surg. 2015;49(6):311-8.
- Baumann K. Gynecomastia - conservative and surgical management. Breast Care (Basel). 2018;13(6):419-24.
- Neyzi O, Alp H, Yalcindag A, Yakacikli S, Orphon A. Sexual maturation in Turkish boys. Ann Hum Biol. 1975;2(3):251-9.
- Güvenç H, Yurdakök M, Kinik E, Büyükgebiz A. The incidence of pubertal gynecomastia in boys living in the Ankara region. Turk J Pediatr. 1989;31(2):123-6.
- Bailey SH, Guenther D, Constantine F, Rohrich RJ. Gynecomastia management: an evolution and refinement in technique at UT Southwestern Medical Center. Plast Reconstr Surg Glob Open. 2016;4(6):e734.
- Cordova A, Moschella F. Algorithm for clinical evaluation and surgical treatment of gynaecomastia. J Plast Reconstr Aesthet Surg. 2008;61(1):41-9.
- Lee YK, Lee JH, Kang SY. Gynecomastia: glandular-liposculpture through a single transaxillary one hole incision. J Plast Surg Hand Surg. 2018;52(2):117-25.
- Brown RH, Chang DK, Siy R, Friedman J. Trends in the surgical correction of gynecomastia. Semin Plast Surg. 2015;29(2):122-30.
- Jin Y, Fan M. Treatment of gynecomastia with prednisone: case report and literature review. J Int Med Res. 2019;47(5):2288-95.
- Collins PS, Moyer KE. Evidence-based practice in liposuction. Ann Plast Surg. 2018;80(6S Suppl 6):S403-5.
- Khalil AA, Ibrahim A, Afifi AM. No-drain single incision liposuction pull-through technique for gynecomastia. Aesthetic Plast Surg. 2017;41(2):298-303.
- Hammond DC. Surgical correction of gynecomastia. Plast Reconstr Surg. 2009;124(1 Suppl):61e-8e.
- Ibrahiem SM. Severe gynecomastia: new technique using superior pedicle NAC flap through a circumareolar approach. Ann Plast Surg. 2016;76(6):645-51.
- Munavalli GS, Panchaprateep R. Cryolipolysis for targeted fat reduction and improved appearance of the enlarged male breast. Dermatol Surg. 2015;41(9):1043-51.
- Fischer S, Hirsch T, Hirche C, Kiefer J, Kueckelhaus M, Germann G, et al. Surgical treatment of primary gynecomastia in children and adolescents. Pediatr Surg Int. 2014;30(6):641-7.
- Abdelrahman I, Steinvall I, Mossaad B, Sjoberg F, Elmasry M. Evaluation of glandular liposculpture as a single treatment for grades I and II gynaecomastia. Aesthetic Plast Surg. 2018;42(5):1222-30.
- Zavlin D, Jubbal KT, Friedman JD, Echo A. Complications and outcomes after gynecomastia surgery: analysis of 204 pediatric and 1583 adult cases from a national multi-center database. Aesthetic Plast Surg. 2017;41(4):761-7.
- Varlet F, Raia-Barjat T, Bustangi N, Vermersch S, Scalabre A. Treatment of gynecomastia by endoscopic subcutaneous mastectomy in adolescents. J Laparoendosc Adv Surg Tech A. 2019;29(8):1073-6.
- Yao Y, Yang Y, Liu J, Wang Y, Zhao Y. Vacuum-assisted minimally invasive surgery-An innovative method for the operative treatment of gynecomastia. Surgery. 2019;166(5):934-9.
Yıl 2020,
Cilt: 22 Sayı: 1, 17 - 22, 30.04.2020
Öz
Aim: Gynecomastia is the visible enlargement of the male breast tissue either due to physiologic, pathologic or drug-related causes. Physiological and pathological gynecomastia occurs because of the derangement of the estrogen and androgen metabolism. Drug-related gynecomastia is seen when using drugs affecting this hormone metabolism as well as a side effect of different drugs. Successful treatment of gynecomastia was reported with medical treatment and cessation of the possible causative drugs especially in early period, and with direct excision, endoscopic subcutaneous mastectomy and excision with liposuction treatments in the late period.
Material and Methods: In this study, we reported our results of gynecomastia treatment with suction assisted wet liposuction in 3 different planes using 3 different thickness cannulas in Grade I, II and III patients. Forty five patients were operated between 2009 and 2019 using this technique in our clinique. All patients were followed for up to a minimum of 6 months to observe the complication rate and the final aesthetic result.
Results: Within the 45 patients evaluated in this study, the complication rate was 6.7%, the success rate of the operation was 93.3% and the patient satisfaction was 91.1%. Gynecomastia treatment in general -especially liposuction- was reviewed and our results were evaluated based on the literature results.
Conclusion: There are many different options for gynecomastia treatment. In this study, we concluded that in Grade I, II, and III patients good results can be achieved and patient satisfaction is high in gynecomastia treatment with wet liposuction.
Material and Methods: In this study, we reported our results of gynecomastia treatment with suction assisted wet liposuction in 3 different planes using 3 different thickness cannulas in Grade I, II and III patients. Forty five patients were operated between 2009 and 2019 using this technique in our clinique. All patients were followed for up to a minimum of 6 months to observe the complication rate and the final aesthetic result.
Results: Within the 45 patients evaluated in this study, the complication rate was 6.7%, the success rate of the operation was 93.3% and the patient satisfaction was 91.1%. Gynecomastia treatment in general -especially liposuction- was reviewed and our results were evaluated based on the literature results.
Conclusion: There are many different options for gynecomastia treatment. In this study, we concluded that in Grade I, II, and III patients good results can be achieved and patient satisfaction is high in gynecomastia treatment with wet liposuction.
Anahtar Kelimeler
Endocrine breast diseases gynecomastia liposuction body contouring
Kaynakça
- Blau M, Hazani R, Hekmat D. Anatomy of the gynecomastia tissue and its clinical significance. Plast Reconstr Surg Glob Open. 2016;4(8):e854.
- Soliman AT, De Sanctis V, Yassin M. Management of adolescent gynecomastia: an update. Acta Biomed. 2017;88(2):204-13.
- Kanakis GA, Nordkap L, Bang AK, Calogero AE, Bártfai G, Corona G, et al. EAA clinical practice guidelines-gynecomastia evaluation and management. Andrology. 2019;7(6):778-93.
- Rasko YM, Rosen C, Ngaage LM, AlFadil S, Elegbede A, Ihenatu C, et al. Surgical management of gynecomastia: a review of the current insurance coverage criteria. Plast Reconstr Surg. 2019;143(5):1361-8.
- Fagerlund A, Lewin R, Rufolo G, Elander A, Santanelli di Pompeo F, Selvaggi G. Gynecomastia: a systematic review. J Plast Surg Hand Surg. 2015;49(6):311-8.
- Baumann K. Gynecomastia - conservative and surgical management. Breast Care (Basel). 2018;13(6):419-24.
- Neyzi O, Alp H, Yalcindag A, Yakacikli S, Orphon A. Sexual maturation in Turkish boys. Ann Hum Biol. 1975;2(3):251-9.
- Güvenç H, Yurdakök M, Kinik E, Büyükgebiz A. The incidence of pubertal gynecomastia in boys living in the Ankara region. Turk J Pediatr. 1989;31(2):123-6.
- Bailey SH, Guenther D, Constantine F, Rohrich RJ. Gynecomastia management: an evolution and refinement in technique at UT Southwestern Medical Center. Plast Reconstr Surg Glob Open. 2016;4(6):e734.
- Cordova A, Moschella F. Algorithm for clinical evaluation and surgical treatment of gynaecomastia. J Plast Reconstr Aesthet Surg. 2008;61(1):41-9.
- Lee YK, Lee JH, Kang SY. Gynecomastia: glandular-liposculpture through a single transaxillary one hole incision. J Plast Surg Hand Surg. 2018;52(2):117-25.
- Brown RH, Chang DK, Siy R, Friedman J. Trends in the surgical correction of gynecomastia. Semin Plast Surg. 2015;29(2):122-30.
- Jin Y, Fan M. Treatment of gynecomastia with prednisone: case report and literature review. J Int Med Res. 2019;47(5):2288-95.
- Collins PS, Moyer KE. Evidence-based practice in liposuction. Ann Plast Surg. 2018;80(6S Suppl 6):S403-5.
- Khalil AA, Ibrahim A, Afifi AM. No-drain single incision liposuction pull-through technique for gynecomastia. Aesthetic Plast Surg. 2017;41(2):298-303.
- Hammond DC. Surgical correction of gynecomastia. Plast Reconstr Surg. 2009;124(1 Suppl):61e-8e.
- Ibrahiem SM. Severe gynecomastia: new technique using superior pedicle NAC flap through a circumareolar approach. Ann Plast Surg. 2016;76(6):645-51.
- Munavalli GS, Panchaprateep R. Cryolipolysis for targeted fat reduction and improved appearance of the enlarged male breast. Dermatol Surg. 2015;41(9):1043-51.
- Fischer S, Hirsch T, Hirche C, Kiefer J, Kueckelhaus M, Germann G, et al. Surgical treatment of primary gynecomastia in children and adolescents. Pediatr Surg Int. 2014;30(6):641-7.
- Abdelrahman I, Steinvall I, Mossaad B, Sjoberg F, Elmasry M. Evaluation of glandular liposculpture as a single treatment for grades I and II gynaecomastia. Aesthetic Plast Surg. 2018;42(5):1222-30.
- Zavlin D, Jubbal KT, Friedman JD, Echo A. Complications and outcomes after gynecomastia surgery: analysis of 204 pediatric and 1583 adult cases from a national multi-center database. Aesthetic Plast Surg. 2017;41(4):761-7.
- Varlet F, Raia-Barjat T, Bustangi N, Vermersch S, Scalabre A. Treatment of gynecomastia by endoscopic subcutaneous mastectomy in adolescents. J Laparoendosc Adv Surg Tech A. 2019;29(8):1073-6.
- Yao Y, Yang Y, Liu J, Wang Y, Zhao Y. Vacuum-assisted minimally invasive surgery-An innovative method for the operative treatment of gynecomastia. Surgery. 2019;166(5):934-9.
Toplam 23 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Nisan 2020 |
| Gönderilme Tarihi | 3 Aralık 2019 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 22 Sayı: 1 |
Kaynak Göster
Cited By
Approach to gynecomastia and pseudogynecomastia surgical techniques and its outcome: a systematic review
Journal of Plastic, Reconstructive & Aesthetic Surgery
https://doi.org/10.1016/j.bjps.2022.02.008
Düzce Tıp Fakültesi Dergisi Creative Commons Atıf-GayriTicari-Türetilemez 4.0 Uluslararası Lisansı ile lisanslanmıştır.