Surgical Managment of Gynecomastia
Conditions
Brief summary
Gynecomastia is the benign proliferation of male breast tissue caused by an increase in the estrogen/androgen activity ratio. It manifests itself physiologically (adolescence, puberty, and old age) as well as pathologically (androgen insufficiency caused by drugs or disease, testicular tumors, hyperthyroidism, and chronic renal failure). * In spite of the variety of methods and tools such as (liposuction and circumareolar inframammary inscion ) used in gynecomastia surgery, in gynecomastia the results are satisfactory in grades 1 and 2 while grades 3 and 4 gynecomastia present a surgical challenge. * As some postoperative frustrating problems still cannot be completely eliminated, the most common of these are a saucer-like deformity (over resection under areola), bleeding, followed by seroma, infection, ischemic necrosis of nipple areola complex residual gynecomastia (under resection), persistence of inframammary fold, contour irregularities, and asymmetries between breasts. * the objective, in this research, is to demonstrate the The role of Benelli technique in removal of gynecomastia grade 3 and grade 4 in clinical and cosmetic outcomes
Detailed description
• The aim of this study the investigator determines the feasibility and cosmetic outcomes of Benelli technique for nipple sparing mastectomy in cases of grade 3 and 4 gynecomastia
Interventions
OTHERBenelli technique for nipple sparing mastectomy in surgical treatment of grade 3 and 4 gynecomastia
.The Nipple areola complex (NAC )margins on both sides are marked as circular. -Around the initial circle, a second circle (external) was drawn 1 cm broader than the boundary. * The skin was resected, with deepithelialization between the two circles. * A transdermal incision was made through the border of the external circle. -. The breast tissue around the pedicle was lifted over the pectoral fascia and excised by preserving the NAC and the underlying breast pedicle * The base of the mammary pedicle under the NAC was infixed at the farthest end of the mastectomy area by using 3/0 absorbable multifilament suture material * Hence, the space formed after mastectomy was filled with a breast pedicle located posterior to the NAC. * The closure of the circular deepithelialized area around the NAC with a diameter of 1 cm accomplished by using 4/0 absorbable monofilament suture material and the surgery was completed
Sponsors
Assiut University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
* The Nipple areola complex (NAC )margins on both sides are marked as circular. * Around the initial circle, a second circle (external) was drawn 1 cm broader than the boundary. * The skin was resected, with deepithelialization between the two circles. * A transdermal incision was made through the border of the external circle. * The breast tissue around the pedicle was lifted over the pectoral fascia and excised by preserving the NAC and the underlying breast pedicle -The base of the mammary pedicle under the NAC was infixed at the farthest end of the mastectomy area by using 3/0 absorbable multifilament suture material * Hence, the space formed after mastectomy was filled with a breast pedicle located posterior to the NAC. * The closure of the circular deepithelialized area around the NAC with a diameter of 1 cm accomplished by using 4/0 absorbable monofilament suture material and the surgery was completed
Eligibility
Sex/Gender
MALE
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* adult male complaining of unilateral or bilateral grade 3 and 4 gynecomastia * pseudo gynecomastia following massive weight loss with excess skin and laxity
Exclusion criteria
* patients with chronic liver failure * hyperthyroidism * Malignant mass * Diabetics * smokers * patients with medical treatment as anabolic steroids .
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Benelli technique for nipple sparing mastectomy in surgical treatment of grade 3 and 4 gynecomastia | baseline | to evaluate and determine the feasibility and complications of benelli techniques for nipple sparing mastectomy in surgical tratment of grade 3 and 4 gynecomastia and also its cosmetic effect |
Countries
Egypt
Outcome results
None listed