Applying the Passot technique in the surgical treatment of severe gynecomastia: A case report and literature review

Abstract

Gynecomastia is emerging as a major cosmetic and physiological concern among adolescents, especially in relation to obesity, acute weight loss following surgery, and other endocrine illnesses. Surgical treatment involves liposuction (mechanical, power-assisted, or ultrasound-assisted), nipple-conserving subcutaneous mastectomies, or nipple transpositions via various techniques. Unsightly scarring, with visible scar hypertrophy and nipple necrosis, continues to plague postoperative cosmetic outcomes; hence, different techniques of performing nipple transposition have been devised, ranging from free grafts to pedicled flaps. In this case report, we draw attention to an old technique, described by Passot in 1925, that was applied primarily for reduction mammoplasty in women at that time. This technique is still not as frequently used as the Wise pattern mastopexy technique in gynecomastia surgery, and we wish to convey that better cosmesis would be achieved in patients with Simon IIB/III and ptotic gynecomastia using this technique, avoiding a vertical scar.