“Nine-step method”mastoscopic scar-hidden surgery on gynecomastia：a single-institution， large sample experiences

Abstract

Abstract Background: To summarize the experiences on the mastopscopic subcutaneous mastectomyfor gynecomastia by "nine-step method"based on the "5S" goal ，and standardize this operation. Patients and methods：Between January 1st 2002 and October 31st 2021，a total of 2035 breasts of 1082 male patients with gynecomastia, of which 129 patients with one side, were underwent mastopscopic subcutaneous mastectomy. Results：All patients were successfully completed the operation, and none of them was transferred to open operation. The operation time for unilateral breast was 12-28 min, and the average time was 17.7±6.2 min. The amount of bleeding during unilateral operation was very small, about 5-10ml. The total drainage volume was 5ml~50ml after the operation, and the drainage tube was removed in 3~5 days. The epidermal necrosis occurred in 0.3% nipple. 0.2% chest wall had a little ecchymosis in the upper- inner region of the breast. All patients had the normal feeling of nipples and areola, the smoothing and symmetrical chest wall, and the natural contour. There was no recurrence during the follow-up period. Conclusions：The mastopscopic subcutaneous mastectomy for gynecomastia by "nine-step method" based on the "5S" goal has a short operation time, few surgical complications and good esthetics. It achieving the "5S" goals on the complete removal of glandular tissue（sweeping）, small and scar-hidden incision are small（scarless）,good symmetry of bilateral chest wall (symmetry), normal chest shape (shape), and smoothing chest wall（smoothing）.