Laser-Assisted Liposculpture Improves Male Gynecomastia Outcomes with Minimal Scarring

Abstract

Background:

Currently, 36% to 40% of men have gynecomastia. Most cases involve excessive subareolar glandular development, an enlarged subareolar region, and adipose cells. When obesity is present, gynecomastia is complicated by the intertwining of glandular breast tissue with enlarged adipose cells. Although direct excision has been the standard technique for fat removal, it is often accompanied by periareolar scars, skin laxity, and other adverse events. Laser-assisted liposculpture removes adipose and glandular tissue in gynecomastia with postsurgical contraction of the skin. The purpose of this article is to evaluate the use of laser-assisted liposculpture for removing glandular and adipose tissue in gynecomastia.

Materials/Participants/Methods:

Forty men (aged 30 to 35 years) with gynecomastia underwent treatment in both breasts with laser-assisted liposculpture. Most participants were overweight but in good overall health. Using Klein's double-strength solution as a local anesthetic, breast tissue was treated using a 4-mm Blugerman disruptor for 3–5 minutes on each side until the tissue became morsalized. Laser-assisted lipolysis was then used on the subareolar bud and remaining fatty and fibrous breast tissue to create tissue coagulation and skin contraction. Energy levels of 1000 J per pass were used, and total energy applied to each breast ranged from 3000 to 5000 J. After treatment, components of the destroyed adipocytes were removed by negative pressure (350–450 mm Hg) through a 3-mm cannula. The small incisions did not require sutures. Patients were examined for symmetry between the treated breasts. Diluted triamcinolone (0.1 mL Kenalog 40 mg/0.9 mL sterile water) was injected beneath the areolar complex to reduce swelling. Patient satisfaction with skin tightening, chest contour, skin smoothness, and reduction of areolar size was graded on a scale of 0 to 10.

Results:

Postsurgical photographs showed reductions in breast tissue volume and more masculine-appearing chests. Patient expectations for outcome were met; satisfaction was generally 8 or higher.

Discussion:

Two earlier studies and the present study show that use of laser-guided lipolysis results in cellular lysis and collagen neoformation. Laser-assisted lipolysis and traditional liposculpture have similar risks and complications: increased asymmetry, waviness, pitting, and cobble-stoning or sagging in breasts. Patients may also develop hematomas, seromas, nerve damage, hypertrophic scars, infection/sepsis, bleeding, persistent edema, and allergic reaction.

Conclusion:

The SmartLipo and SlimLipo laser-assisted liposculpture systems can be used on most anatomic regions. Both offer reduced treatment time, smoother skin and less contour deformities, improved healing, less bruising, and reduced pain compared with traditional lipolysis.