ADVANTAGES OF BIPEDICLE OVER UNIPEDICLE PERIAREOLAR INCISION IN LIPOSUCTION ASSISTED WEBSTER'S PROCEDURE FOR GRADE II GYNAECOMASTIA

Kannamani Saravanan; Shanmugam Sridevi; Pakkiri Sathya

Volume : VII, Issue : XII, December - 2018

ADVANTAGES OF BIPEDICLE OVER UNIPEDICLE PERIAREOLAR INCISION IN LIPOSUCTION ASSISTED WEBSTER'S PROCEDURE FOR GRADE II GYNAECOMASTIA

Kannamani Saravanan, Shanmugam Sridevi, Pakkiri Sathya

Abstract :

Background:–

Gynaecomastia is a benign enlargement of the male east tissue, due to proliferation of glandular tissue or fat deposition or both. Bilateral occurrence is most common. Etiology is mainly due to imbalance of estrogen and androgen hormones in the body. Gynaecomastia in young adolescence is a social stigma, leading to lack of self confidence. Removal of east tissue plays a vital role in treatment modalities. Complete excision of east tissue in grade II gynaecomastia through unipedicle periareolar incision poses difficulty due to limited access. Hence it was decided to study the advantages of bipedicle periareolar incision over unipedicle periareolar incision.

Aim and objective:–

To analyse the advantages and post operative outcomes of bipedicle over unipedicle periareolar incision in the removal of east tissue following liposuction assisted Webster’s procedure [LAW] in grade II gynaecomastia.

Methods:–

This is a two year prospective study (Jan2016 – Dec2017) done in our Department of Plastic, Reconstructive and Faciomaxillary surgery, Madras medical college(MMC) and Rajiv Gandhi Government General hospital ( RGGGH), Chennai. Sample size was of 20 cases of Grade II bilateral gynaecomastia. Liposuction was done by super wet tumescent (near– tumescent) technique.

Group A :– 10 cases of unipedicle periareolar incision of liposuction assisted Webster’s procedure

Group B :– 10 cases of bipedicle periareolar incision of liposuction assisted

Webster’s procedure

Results:–

Our two year study included 20 cases of grade II gynaecomastia. Liposuction assisted Webster’s procedure were done in all cases. Effective analysis of average time of excision per east tissue was done in both groups. In Group A (unipedicle incision) it was 11 minutes whereas in Group B (bipedicle incision) it was only 5 minutes duration. Average hospital stay was 3 days in both groups. Group B showed easy accessibility for complete excision of glandular east tissue and contour of the pectoral chest wall was smooth and regular after the procedure as compared to Group A.

Conclusion:–

In grade II gynaecomastia, surgical removal of excess fat or glandular tissue plays an imperative role. It regained assertiveness in young adolescence thereby decreasing social trauma. Our study concludes that postoperative outcomes of Group B ( bipedicle periareolar incision) are better acceptable than Group A ( unipedicle periareolar incision) in terms of easy and quick access to the east tissue as reflected in the decreased average time of excision per side, less number of complications like haematoma and pectoral chest wall contour irregularities due to wider exposure with bipedicle periareolar incision especially in grade II gynaecomastia.