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Power-Assisted Liposuction and the Pull-Through Technique for the Treatment of Gynecomastia

Lista, Frank M.D.; Ahmad, Jamil M.D.

Plastic and Reconstructive Surgery: March 2008 - Volume 121 - Issue 3 - p 740-747
doi: 10.1097/01.prs.0000299907.04502.2f

Background: Gynecomastia is a common condition affecting many adolescent and adult males. Surgical techniques utilizing a variety of incisions, excisions, suction-assisted lipectomy, ultrasound-assisted liposuction, power-assisted liposuction, or some combination of these methods have been used in the treatment of gynecomastia. This article describes the authors' method of using power-assisted liposuction and the pull-through technique to treat gynecomastia.

Methods: This technique involves the use of power-assisted liposuction to remove fatty breast tissue. The pull-through technique is then performed utilizing several instruments to sever the subdermal attachments of fibroglandular breast tissue; this tissue is removed through the incision used for liposuction. Finally, power-assisted liposuction is performed again to contour the remaining breast tissue. A chart review of 99 consecutive patients (197 breasts) treated between January of 2003 and November of 2006 was performed.

Results: Ninety-six patients (192 breasts) were successfully treated using this technique. Power-assisted liposuction was performed in all cases, and the average volume aspirated per breast was 459 ml (range, 25 to 1400 ml). Using the pull-through technique, the authors were able to remove between 5 and 70 g of tissue per breast. Complications were minimal (1.0 percent of breasts), and no revisions were required.

Conclusions: Since January of 2003, the authors have used this technique to successfully treat 97 percent of their gynecomastia patients. Combining power-assisted liposuction and the pull-through technique has proven to be a versatile approach for the treatment of gynecomastia and consistently produces a naturally contoured male breast while resulting in a single inconspicuous scar.

Mississauga, Ontario, Canada; and Dallas, Texas

From the Plastic Surgery Clinic; Division of Plastic Surgery, Trillium Health Center; and Department of Plastic Surgery, University of Texas Southwestern Medical Center.

Received for publication April 10, 2007; accepted May 29, 2007.

Presented at the 61st Annual Meeting of the Canadian Society of Plastic Surgeons, in Banff, Alberta, Canada, June 2, 2007.

Disclosure:Neither author has any financial interest with any of the products, devices, or drugs mentioned in this article.

Frank Lista, M.D., The Plastic Surgery Clinic, 1421 Hurontario Street, L5G 3H5, Mississauga, Ontario, Canada,

©2008American Society of Plastic Surgeons