Zhou Xiaowu, Gu Guoli, Feng Guoxun, Wang Shilin
Gynecomastia is the most common type of male breast disease.
The previous surgical methods include open excision, simple liposuction, and a combination of both [1].
The previous surgical methods include open excision, simple fat aspiration, and a combination of both [1]. Open mastectomy is invasive and the chest wall incision is large.
The open excision is very traumatic and the chest wall incision scar is large, which affects the appearance, while the fat aspiration gland is not completely removed by the general surgery department of Air Force General Hospital, Zhou Xiaowu.
The disadvantages of both are obvious. We use
We used the lumpectomy technique to perform complete excision of the gland with both minimally invasive advantages and
The results are satisfactory and are reported below.
I. Data and methods
1 General data: From December 2008 to March 2009, two cases were admitted to the PLA Air Force General Hospital.
Two patients with gynecomastia were admitted to the General Hospital of the People’s Liberation Army Air Force from December 2008 to March 2009. Case
Case 1, 21 years old, had left mammary gland enlargement for 2 years, with a diameter of 10 cm and a height of 4 cm.
Case 2, 24 years old, had bilateral breast enlargement for 10 years, and the left breast was 13 cm in diameter and 5 cm high.
The left breast was 13 cm in diameter and 5 cm in height, while the right breast was 10 cm in diameter and 4 cm in height (Figure 1).
(Figure 1).
The right breast was 10 cm in diameter and 4 cm in height (Figure 1).
The upper limb was fixed on the head frame. A 1 cm longitudinal incision was made in the ipsilateral axilla in the mid-axillary line at 2 cm.
A 1 cm longitudinal incision was made at the mid-axillary line on the same side, and 1:1,000 adrenal physiological saline was injected subcutaneously.
saline, free the flap, create a lumpectomy space, place a 10 mm
Trocar, a 30° laparoscope was placed as a viewing hole, and CO2 pressure was maintained at 6 mm Hg.
A 10 mm Trocar was placed 3 cm below it as the main operating hole, and a 10 mm Trocar was placed 3 cm below it as the main operating hole.
The 10-mm Trocar was placed 3 cm below it as the primary operating hole and the 5-mm Trocar was placed 3 cm below it as the secondary hole (Figure 2).
The subcutaneous tissue on the superficial side of the breast is first freed with an ultrasonic knife or an electric spatula so that the
the entire mammary gland can be visualized, and then the deep side is freed from the pectoralis fascia surface.
The entire breast tissue is then freed from the surface of the pectoralis fascia. The lumpectomy of the wound is stopped and a rubber drain is placed.
One rubber drain was placed and fixed through the auxiliary hole, and the incision was sutured after surgery.
II. Results
The specimen was removed completely after slightly enlarging the main operation hole. Intraoperative bleeding
The drainage tube was removed 3 to 5 days after surgery, and the specimen was discharged 7 to 8 days after surgery.
Both cases had no nipple or flap necrosis, no subcutaneous emphysema, and excellent postoperative cosmetic results (Figure 3).
The postoperative cosmetic results were excellent (Figure 3). The results were satisfactory at 6 months of follow-up.
Author Affiliation: Department of General Surgery, PLA Air Force General Hospital, Beijing, 100142, China
Corresponding author: Xiaowu Zhou, Email: [email protected]
III. Discussion
Gynecomastia, or gynecomastia, generally does not require treatment.
treatment is generally not needed, but if significant hypertrophy affects the appearance, or if malignancy is suspected, surgical excision is often required.
Surgical excision is often required if the enlargement affects the appearance or if malignancy is suspected. Surgical methods include mastectomy with preservation of the nipple
The two types of surgical procedures are mastectomy with nipple preservation and simple mastectomy (without nipple preservation).
As people’s standard of living improves and their aesthetic requirements increase accordingly, nipple-preserving mastectomy is more popular among younger patients.
The nipple-preserving mastectomy is more popular among young patients [2]. The traditional surgical procedure
The traditional surgical procedure is to make an incision through the surface of the breast, which leaves a large incision scar and affects the aesthetics.
Since the 1980s, with the development of minimally invasive surgery, lumpectomy is no longer a surgical procedure.
Since the 1980s, with the continuous development of minimally invasive surgery, lumpectomy is no longer limited to cavities such as the abdominal cavity.
In the 1980s, with the continuous development of minimally invasive surgery, lumpectomy was no longer limited to cavities such as the abdominal cavity, but began to develop in areas without cavities or potential cavities. Laparoscopic breast
In China, lumpectomy is still in the exploration stage.
The lumpectomy alone is a new attempt to treat gynecomastia.
The mastectomy alone with lumpectomy technique is a new attempt to treat gynecomastia and has been little reported in China. Through a small, concealed incision in the axilla, a large incision in the anterior chest wall can be avoided.
The postoperative cosmetic effect is good. Our experience
The key aspects of successful surgery are: (1) to start the surgery before
(1) The scope of free excision should be determined in the chest wall before starting the surgery, so that the subcutaneous fatty tissue is not mistaken for breast tissue and
(2) the nipple area should be removed by ultrasonic knife.
(2) the nipple area should be removed with ultrasonic knife to ensure good blood supply to the nipple.
The freeing of the nipple should not be too deep or too shallow, but can be facilitated by pulling the nipple upward with the fingers.
The freeing of the lower nipple should not be too deep or too shallow. The external nipple can be removed with the help of an electric spatula.
This can shorten the operation time.
(See CD for pictures of this article)
References
[1] Niu Zhaohe, Luan J, Mu Lanhua, et al. Classification and treatment of gynecomastia. Plastic
Journal of reconstructive surgery, 2006, 3(6): 78 -80.
[2］ Chen Li-Zhong, Chen Qiong-Xia. 112 cases of gynecomastia. Chinese Journal of Endocrine Surgery
Chinese Journal of Endocrine Surgery, 2009, 3(3): 200, 205.
(Date of receipt: 2009 Sing 12 16)
(Editor: Zhou Lei)
Chinese Journal of Clinicians (Electronic Edition), Vol. 4, No. 3, March 2010 Chin J Clinicians (Electronic Edition), March 15, 2010, Vol. 4, No. 3 ・ 91.
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