保留乳晕及外下侧薄层乳腺瓣的男性乳腺抽吸辅助切除术

Treatment of gynecomastia by liposuction assisted excision with conservation of areolar and thin layer mammary gland in the lateral-inferior area

目的探讨保留乳晕及外下侧皮下薄层乳腺瓣，结合肿胀抽吸辅助乳晕小切口男性乳腺切除术的临床应用及其疗效。方法术前患者采取站位，标记拟切除的乳腺范围、脂肪抽吸范围、两者的过渡区以及拟保留的近三角形薄层乳腺瓣区域，肿胀麻醉后，先进行脂肪抽吸后，经乳晕小切口行保留乳晕及外下侧皮下薄层乳腺的男性乳腺切除术。结果本组患者13例（26只乳房），均为男性乳腺增生症，术后胸部塑形效果好，切口Ⅰ期愈合，无明显并发症，6例患者随访3～9个月，胸部形态平坦美观，触之无异常肿块和结节。结论经初步临床结果验证，该方法可行，美容效果好，并能有效预防乳头乳晕感觉减退、皮肤血运不良、血肿以及血清肿并发症的发生。

Objective To explore the modified liposuction and excision method with conservation of areolar and thin layer mammary gland in the lateral-inferior area for treatment of gynecomastia. Methods The extent of the mammary gland which would be excised, extent of liposuction, transition zone between them and the reserved extent of triangle thin layer of mammary gland were marked before the operation. Under anaesthesia, after liposuetion, the male masteetomy was performed through a small incision along the medial margin of the areolar with reserving areolar and thin layer of mammary gland in the lateral-inferior area. Results Thirty - six breasts from 13 patients with gynecomastia were treated with this method, all of them were primarily cured without any complications such as hematoma or seroma, decreased sensation of nipple and areola, skin necrosis. Six patients were followed up for 3 - 9 months, the shape of the breasts was flat and beautiful without abnormal tumours and nodus. Conclusion It is feasible for treating gyneeomastia by the modified liposuction and excision method with conservation of thin layer of mammary gland. It can also prevent decreased sensation of nipple and areola, bad circulation of blood and occurrence of complications such as hematoma and seroma.