Correction of Gynecomastia with Combination of Ultrasonic Liposuction (VASER) and Gland Excision through a Minimal Scar Incision: A Multi-Center Experience.

Abstract

Background: Gynecomastia is a common condition among men, leading to psychological distress and impacting quality of life. Traditional correction techniques often result in prominent scarring, which can be a major concern for patients. This study explores the efficacy of combining VASER liposuction with gland excision through a minimal scar approach to improve aesthetic outcomes.

Methods: This study retrospectively analyzed 960 patients treated between October 2009 and January 2024 at two centers located in Dubai and Riyadh. Patients were classified using Simon's grading system. The surgical procedure included VASER-assisted liposuction targeting the chest, lateral chest, and axillary fold areas, followed by gland excision through a minimal scar incision. Satisfaction was assessed using both patient- and physician-reported Visual Analogue Scale (VAS) scores. Ethical approval was obtained from the Dubai Scientific and Research Ethics Committee (DSREC) and the Institutional Review Board (IRB) at Hasan Surgery and The Clinics Riyadh KSA.

Results: Patient distribution by Simon grading was: Grade I (16.7%), Grade IIA (41.7%), Grade IIB (29.2%), and Grade III (12.5%). Mean aspirated fat volume was 859.4 ml. Patient satisfaction was high, with a mean VAS score of 9.4 across all grades, and minor complications such as bruising, temporary sensory loss, and hematomas occurred in 1.7% of cases. Physician-assessed VAS scores mirrored patient satisfaction, demonstrating the reliability of the technique in achieving minimal scarring, significant skin retraction, improved contouring, and high satisfaction rates.

Conclusion: Combining VASER-assisted liposuction with gland excision through a minimal scar incision is a highly effective approach for gynecomastia correction. The technique delivers superior aesthetic outcomes, minimal scarring, and high satisfaction across all grades of gynecomastia. Further long-term studies are recommended to assess delayed recurrence.

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