Comparison of Non-liposuction and Liposuction Techniques in Single-port Endoscopic Subcutaneous Mastectomy for Gynecomastia: A Retrospective Analysis.

Background: Gynecomastia (GM) is a common benign proliferation of male breast tissue that can significantly impact patients' physical and mental health. Endoscopic subcutaneous mastectomy (ESCM) has emerged as a promising minimally invasive approach for treating GM. However, the relative efficacy of different techniques for creating operative space during ESCM remains unclear. This study aims to compare the clinical outcomes of non-liposuction and liposuction techniques in single-port ESCM for GM treatment.

Methods: This retrospective study included 41 GM patients who underwent single-port ESCM via bilateral axillary approach at Shandong Maternal and Child Health Hospital between September 2022 and September 2023. Patients were divided into non-liposuction (n=20) and liposuction (n=21) groups. Operative time, blood loss, postoperative drainage volume, complication rates, and patient satisfaction were compared between the two groups.

Results: All procedures were successfully completed without conversion to open surgery. The non-liposuction group had significantly shorter mean operative time compared to the liposuction group (124.30 vs 168.81 minutes, P<0.001). Postoperative day 1 drainage volume was also significantly lower in the non-liposuction group (43.40 vs 107.05 mL, P<0.001). No significant differences were observed in intraoperative blood loss, complication rates, or patient satisfaction between the two groups. The overall complication rate was 7.3% (3/41), with two cases in the liposuction group and one in the non-liposuction group. No recurrences were reported during the 12-month follow-up period.

Conclusion: Single-port ESCM is a safe and effective method for treating GM. Compared to the liposuction technique, the non-liposuction approach demonstrates significant advantages in reducing operative time and postoperative drainage volume while maintaining comparable safety and patient satisfaction. These findings provide new insights for optimizing GM treatment strategies and potentially improving patient outcomes.

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