内镜乳晕小切口男性乳房肥大矫正术

目的探索减少男性乳房肥大整形术后瘢痕,使乳房切除更加精确,更有利于塑形,避免出血、血肿及支配乳头、乳晕感觉神经的损伤。方法对16例患者在内镜监视下,采用乳晕旁2~3.5cm切口,切除肥大的男性乳腺腺体组织,对于以脂肪增生为主者,先行肿胀吸脂术,后在内镜监视下进行残余肥大腺体切除。切除乳腺体组织量单侧为100~320g,平均为130g;吸脂量为20~130ml,平均为68ml,无血肿,切除组织病理检查为脂肪组织及腺体组织。结果术后无血肿,无皮肤坏死,乳头及皮肤的感觉良好,均获随访观察,时间为手术后5个月至3年,无复发。结论内镜外科技术能缩小乳晕切口,避免损伤乳头、乳晕,利于离乳晕较远范围的乳腺组织切除及乳房重新塑形,为男性乳房肥大矫正的一种良好选择。

Aesthetic correction of gynecomastia under endoscope through a small incision of mammary areola combined with tumescent liposuction

Objective To gain the best cosmetic result and to avoid the manifest postoperative scar, bleeding and injury of the sensory nerves in the nipple and areola. Methods The gynecomastia was corrected under the endoscope through a small incision (2~3.5 cm) around the areola combined with the tumescent liposuction of the breast to individuals whose breast hyperplasia was mainly because of the fat tissue hyperplasia and the incised tissues were sent for pathological examinations. Results Since March 2000, 16 young men with normal men genitals appearance had undergone this operation, in which 4 cases were breast gland tissue hyperplasia, 3 cases of fat tissue hyperplasia and 9 cases of mixed fat and gland tissue hyperplasia. The results were satisfactory with normal men breast appearance and small areola incisions. No complications happened such as hematoma, abnormal feeling and necrosis in nipple and the breast. The incised tissue of the unilateral breast was 100~320g with average of 130g. The sunction lipectomy volume of the unilateral breast was 20~130ml with average of 68ml. The pathological examination revealed that the incised tissue were fat tissue and breast gland tissue. During 5 months to 3 years following up, no breast hyperplasia recurred. Conclusions The endoscopic operative technique is an ideal option to correct the gynecomastia because it minimizes the areolar incision and avoids the injury of the nipple and areola. It is also helpful to the distal part incision and remoulding of the breast.