A recently released study suggests that a specific surgical technique for correcting gynecomastia as part of comprehensive body contouring surgery is both safe and effective for correcting gynecomastia in patients who have shed significant amounts of weight.
The authors, Dennis J. Hurwitz, M.D., and Lino F. Miele, M.D., both of the University of Pittsburgh, say the technique — referred to as boomerang-pattern correction — is most effective when combined with other torsoplasties to produce an aesthetically pleasing total body lift in male weight-loss patients.
Drs. Hurwitz and Miele note that after excess skin and fat are removed, a traditional body lift advances skin and suspends ptotic breasts, mons pubis and buttocks.
“For women,” they write, “the lift includes sculpting their adiposity. While some excess fat may need removal, muscular men should receive a deliberate effort to achieve generalized tight skin closure to reveal superficial muscular bulk.”
To accomplish that goal more effectively and aesthetically, the authors designed a series of opposing elliptical excisions — each boomerang-shaped — that join above the nipple and extend transversely to complete the upper body lift (UBL). They compare the boomerang-pattern technique to a fleur de lis abdominoplasty in the lower torso.
The ‘Boomerang’ Study
For their study, Drs. Hurwitz and Miele reviewed and analyzed the office charts of 24 patients who had undergone boomerang-pattern correction of gynecomastia since 2002 and had more than one year of follow up. In their last 12 patients, a J torsoplasty extension replaced the transverse UBL. Eleven patients had an extended abdominioplasty with oblique excisions over bulging flanks to complete effacement of the torso.
The authors report they observed satisfactory improvement in all 24 boomerang cases, although one patient was displeased with distorted nipples following revision surgery. They also note that maturation of scars is a lengthy process, with some taking years to flatten and fade. A limited number of complications were reported and no major revisions were required.
“In selected patients, comprehensive body-contouring surgery consists of a boomerang correction of gynecomastia, and J torsoplasty with an abdominoplasty and oblique excisions of the flanks has proven to be a practical means to achieve aesthetic goals,” the authors conclude. “Gender-specific body-lift surgery that goes far beyond the treatment of gynecomastia best serves the muscular male patient after massive weight loss.”
The study appears in the February issue of Plastic and Reconstructive Surgery.
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