New Surgical Technique Helps Treat Pseudogynecomastia

A novel excisional approach helps male patients with pseudogynecomastia following massive weight loss (MWL), according to a new study.

Developed by researchers at the University of Texas (UT) Southwestern Medical Centre (Dallas, TX, USA) and in private practice, the technique involves a modified elliptical excision and nipple-areola complex (NAC) transposition on a thinned inferior dermal pedicle, in addition to liposuction, as an alternative to conventional mastopexy body contouring procedures for treating male chest deformity after MWL, which often leads to suboptimal results. The researchers reported the results of a retrospective chart review in 14 male patients, who were followed for an average of 8.1 months.

The patients were characterized by age, method of weight loss, pre-weight loss body mass index (BMI), post-weight loss BMI, total weight loss, grade of pseudogynecomastia, and concurrent procedures. The average weight lost was 79.72 kg, with pre-weight loss BMI averaging 52.0 kg/m² and post-weight loss BMI 29.6 kg/m². The average amount of tissue removed was 2,615 grams. In all, 28.6% of the patients experienced minor complications, including asymmetry, delayed wound healing, hyperpigmentation, and seroma. There were no wound infections, hematomas, flap necrosis, or dysesthesia. The study was published on June 16, 2020, in Aesthetic Surgery Journal: Open Forum.

“Due to several cosmetic advantages and low complication profile, our technique is an attractive option for treating male chest deformity after MWL,” concluded senior author Professor Jeffrey Kenkel, MD, of UT Southwestern Medical Center, and colleagues. “This is a nice alternative to the standard nipple grafting techniques we have used for years. It allows us to preserve the shape of the nipple and in many cases the color in patients of color.”

Pseudogynecomastia is defined by retained retroareolar fat without glandular hypertrophy, often with excess tissue and skin anteriorly and laterally; this in contrast to gynecomastia, which is often idiopathic and results in proliferation of glandular tissue. Treatment for pseudogynecomastia generally requires excision of excess tissue and skin for all but the mildest forms.

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University of Texas Southwestern Medical Centre