乳晕切口吸脂法治疗男性乳腺发育症七例报告

Liposuction with areola incision for treatment of gynecomastia： a report of 7 cases

目的 探讨经乳晕微创小切口加吸脂治疗男性乳房发育症的临床应用及美容效果.方法 男性乳腺发育症患者7例,治疗方法均采用乳晕微创切口加吸脂法皮下腺体全切.先行在需切除的乳房肥大区域皮下脂肪层注射脂肪裂解液,乳晕旁取1.0 ～2.0 cm切口,插入负压吸引器抽吸该区域内的脂肪组织,再经切口逐条切除腺体及残存的脂肪组织.术毕切口用可吸收线皮下缝合或皮肤粘合剂粘合,创面加压包扎.结果 7例患者切口均达到Ⅰ期愈合、胸部外观自然、平坦对称、触摸无凹凸不平感,无明显切口疤痕.乳头、乳晕均无坏死,单侧手术时间40～90 min,平均约60 min,出血量30 ～ 60 mL,平均40 mL.l例出现局部血肿,经畅通引流继续加压包扎后痊愈.1例患者术后出现乳头乳晕麻木,随访1～3个月后感觉恢复正常.结论 经乳晕微创小切口加吸脂治疗男性乳房发育症,操作简单安全,恢复较快,达到治愈及美容效果.

Objective To explore the surgical application and cosmetic effect of minimally invasive small excision supplement with liposuction in the treatment of gynecomastia.Methods 7 patients were diagnosed as gynecomastia.All patients were given minimally invasive excision.The procedure was carried out by minimally invasive excision on areola plus liposuction subcutaneous glandular.Following the procedure,fat lysate was infused into adipose layer surrounding breast hypertrophy region.A 1-2cm areola incision was made.Fat tissue was removed by using negative pressure aspirator suction.Finally,the whole glands and residual fat tissue were cleared away.Following the surgery,subcutaneous suture and skin adhesive bonding,and wound compression bandage were applied to the area with surgical incision.Results All patients achieved grade Ⅰ gynecomastia with minimally invasive small excision.Their chests had natural,smooth and symmetrical appearance.There were no uneven feeling and obvious incision scar,also no necrosis in the nipple and areola.The average operation time was 60 min for unilateral surgery （40-90min）.The average bleeding was 40mL （30-60mL）.One patient had local hematoma,but got better following continued compression bandage.One patient was observed numbness in nipple areola.But it disappeared after 1-3 months follow-up.Conclusion Our experience with minimally invasive breast surgery for gynaecomastia continues to give excellent results of cosmesis with minimum morbidity.