肿胀吸脂联合乳晕下弧形切口治疗中重度男性乳房肥大症

目的探讨肿胀麻醉吸脂联合乳晕下缘弧形微创切口腺体切除术治疗男性乳房肥大的方法和临床疗效。方法自2002年4月—2012年6月,收治29例男性乳房肥大患者。年龄16～47岁。单侧3例,双侧26例。其中脂肪型14例,脂肪混合型13例,腺体型2例。其中3例PRL、LH、FSH、E2水平增高,睾酮水平较低;其余患者体内相关激素水平正常,以上患者均采用肿胀吸脂联合乳晕下弧形切口腺体切除术。结果 1例患者于术后2 d出现皮下血肿,经对症处理后最终一期愈合;1例乳头下乳腺组织残留过多,经二次整复后效果满意,其他病例切口均Ⅰ期愈合。未见乳头、乳晕缺血、坏死及乳头感觉功能减退等并发症发生。20例患者随访,随访日期6～24个月,乳房外形良好,无复发。结论肿胀吸脂联合乳晕下弧形切口腺体切除术具有瘢痕小、安全性高、外观自然、患者满意度高等优点,是目前治疗男性乳房发育有效方法之一。

Study on the Treatment of Moderate and Severe Gynecomastia by Liposuction Combined with Semicircular Periareolar Incision Glandular Organ Resection

Objective To investigate the treatment effect of liposuction combined with semicircular periareolar incision glandular organ resection on moderate and severe gynecomastia. Methods 29 male patients with gynecomastia, aged from 16 to 47, were admitted to our hospital from April, 2002 to June, 2012. Of whom, there were 3 cases of unilateral, 26 cases of bilateral; 14 cases of fat type, 13 cases of mixed type, and 2 cases of glandular type. The levels of serum prolactin, luteinizing hormone, follicle stimulating hormone, estradiol and testosterone were normal in 26 patients, while in the other 3 patients, the levels of serum prolactin,luteinizing hormone, follicle stimulating hormone and estradiol were higher than normal, and the testosterone level was lower. All the patients were treated with liposuction combined semicircular periareolar incision glandular organ resection. Results Except for2 cases in which one happened hematoma 2 days after operation and eventually healed by first intention after symptomatic treatment; 1 case of breast tissue residues in excess under nipple then obtained satisfactory effect after the second repair operation, the other cases all obtained healing by first intention. There were no complications such as nipple and mammary areola necrosis and nipple hypesthesia. 20 patients were followed up for 6-24 months.They were satisfied with their chest shape and no recurrence was observed. Conclusion Liposuction combined with semicircular periareolar incision glandular organ resection has many advantages in the treatment of gynecomastia, such as small scar, high safety, natural appearance and high patients＇ satisfaction. At present, it is one of the effective methods for the treatment of gynecomastia.