Study On Liposuction Combined With Small Incision Removal Of Glandular Tissue And Simple Surgical Resection In The Treatment Of Gynecomastia

Objective To investigate the curative effect of two different surgical methods in the treatment of male breast development and to select the more advantageous surgical methods.Methods 132 patients with male breast development from March 2012 to June 2018were analyzed retrospectively.According to the different operative methods,they were divided into liposuction combined with small incision removal of glandular tissue group（minimally invasive group）and open simple open surgical resection group（open group）.The therapeutic effects of the two groups were observed.The anesthetic methods,hospitalization time,postoperative pain score（Wong-Baker facial expression score）,complications,postoperative incision scar and overall satisfaction were compared and analyzed statistically.Results Both groups were effective in the treatment of male breast development.the minimally invasive group completed the operation under the awake state of intravenous assisted local swelling anesthesia,and the open group completed the operation under general anesthesia.The average operation time was（148.18±46.04）min,in the minimally invasive group and（3.21±1.29）days in the open group,and（136.09±32.82）min,in the open group,and（7.57±1.71）days in the open group.The time points before operation,3 hours after operation,6 hours after operation,24 hours after operation and 48 hours after operation were T₀,T₁,T₂,T₃ and T₄.The pain score at T₀time point in minimally invasive group and open group was 0.The pain score at T₁ point in minimally invasive group was（2.25±0.54）,and the pain score at T₁ point in open group was（4.00±0.90）.The pain score in minimally invasive group was lower than that in open group.The pain score was（2.48±0.54）in the minimally invasive group and（4.93±0.72）in the open group at T₂,and the pain score in the minimally invasive group was lower than that in the open group（P<0.05）,and the pain score was（2.48±0.54）in the minimally invasive group and（4.93±0.72）in the open group.The pain score at T₃ time point was（1.92±0.50）in the minimally invasive group and（2.69±0.80）in the open group,and the pain score in the minimally invasive group was lower than that in the open group（P<0.05）,and the pain score was（1.92±0.50）in the minimally invasive group and（2.69±0.80）in the open group.The pain score was（1.37±0.52）in the minimally invasive group and（1.44±0.50）in the open group at T₄,and the pain score in the minimally invasive group was lower than that in the open group（P<0.05）,and the pain score was（1.37±0.52）in the minimally invasive group and（1.44±0.50）in the open group.However,there was no significant difference between the two groups（P>0.05）,the pain score of the minimally invasive group was lower than that of the open group,the pain score of the minimally invasive group was lower than that of the open group,and the pain degree of the minimally invasive group was still lower than that of the open group at 24 hours after operation,but there was no significant difference between the two groups（P>0.05）.The pain was basically relieved 48 hours after operation,and the pain in the minimally invasive group was similar to that in the open group.Most of the patients in the minimally invasive group scored less than 3 points after operation,and the patients said they could bear it.The operation time in the minimally invasive group was shorter than that in the open group,but the difference was not statistically significant（P>0.05）.The scar VSS score was（2.21±0.47）and the overall satisfaction was（3.33±0.57）in the minimally invasive group,and（5.44±0.95）and（2.31±0.50）in the open group.Chi-square test showed that the scar score of patients undergoing minimally invasive surgery was lower than that of open surgery,and the overall score was higher than that of open surgery,the difference was statistically significant（P<0.05）.Complications included hematoma,serum swelling,skin necrosis,incision infection and so on.the incidence of postoperative complications in the minimally invasive group was significantly lower than that in the open group（P<0.05）.Conclusion Minimally invasive surgery is a low invasive operation with small incision.It can be carried out under local anesthesia in outpatient operating room.The risk of operation is small,the complications are very few,the postoperative recovery is fast,the hospitalization time is short,and it does not affect the normal life basically.And the intraoperative and postoperative pain is light,the effect is good,the scar is concealed,and the patient’s satisfaction with the postoperative breast shape is also high.The open operation is an invasive operation,the incision is large,the operation needs to be hospitalized under general anesthesia,the risk of operation and anesthesia is high,and the complications are relatively more.The postoperative recovery time was slow,the hospitalization time was long,the activity was limited,the postoperative pain was severe,and the scar was obvious.In the treatment of mild to moderate male breast development,the results of minimally invasive small incision combined with liposuction under swelling anesthesia are satisfactory and worthy of popularization and application.