Water-Jet-Assisted Liposuction for the Treatment of Grade I and II Gynecomastia

利用水刀抽脂修正男性女乳症

王惠琳(Christina Hu-LinWang) ； 謝綺瀅(Chi-Ying Hsieh) ； 游彥辰(Yen-Chen Yu) ； 阮廷倫(Tyng-Luen Roan) ； 陳右昇(Yo-Shen Chen) ； 張克中(Ke-Chung Chang) ； 林佐武(Tsuo-Wu Lin)

《臺灣整形外科醫學會雜誌》 25卷2期 (2016/06) Pp. 118-127

摘要

背景：男性女乳症的特徵就是在男性身上有類似女性乳房的膨出，這些外觀往往會造成患者社交時的尷尬及很大的心理壓力。而膨大的組織包含一些乳房腺體、基質及脂肪細胞，而且通常並不一定有形成的特殊原因。大部分持續性的男性女乳症皆可考慮使用外科的方式治療。目的及目標：目前男性女乳症大多以各種抽脂的技術來進行治療。水刀抽脂於2007年推出，其獨特的抽脂管設計可產生脈動式的扇形水柱切割及剝離組織，並同時利用負壓的吸力將剝離的軟組織吸出。目前本院經常性地使用水刀抽脂的技術在需要形體雕塑的病人身上，而我們也固定地利用此技術來治療具有男性女乳症的患者。材料及方法：從2010年至2014年，本院共有18位男性被診斷具有男性女乳症而採用水刀抽脂進行治療。使用水刀抽脂後，若還覺得乳頭及其周遭仍具有突出，可經由乳暈旁的切口進行局部的拖出式切除術。手術雖採全身麻醉但不需住院，也不放置引流管。傷口於術後用紗布包紮，並立即穿著上術前量身訂作的彈性背心，且會要求病患穿戴此背心至少一個月。結果：手術後一個月，我們利用問卷調查詢問患者對手術的滿意度，其中內容包含：(1)術後對疤痕的滿意度，(2)術後對胸廓外型改變的滿意度，以及(3)術後對外表改變後自信心的變化。患者將自己的滿意度用分數1到10來評分，其中以10分代表為最滿意，病患於以上三個問題，皆給予平均9分以上的滿意度。結論：通過上述結果，可知利用水刀抽脂合併局部的拖出式切除術是可以有效的治療男性女乳症Rohrichclassification第一級及第二級患者。

並列摘要

Background: Gynecomastia is characterized by male breast enlargement on the chest wall, creating a feminine-looking upper torso profile that can be a source of great psychological stress and social embarrassment. The enlargement, most often idiopathic, is caused by mixture of ductal, stroma, and/or fat tissue proliferation in the region, and surgical correction can be considered in most cases of persistent gynecomastia. Aim and Objectives: Current surgical treatment of gynecomastia involves various liposuction techniques. Water-jet-assisted liposuction (WAL), introduced in 2007 as a thirdgeneration liposuction technique, uses a dual-purpose cannula that emits a pulsating, fan-shaped water jet while simultaneously removing soft tissue through aspiration. The pulsating water jet is designed to break down soft tissue while performing the aspiration procedure. Currently, it is a popular option in body-contouring procedures at our institution, and we use it on a regular basis to treat gynecomastia. Materials and Methods: From 2010 to 2014, 18 male patients diagnosed with gynecomastia were treated at our institution with water-jet-assisted liposuction. An additional pull-through procedure was carried out in an area directly underneath the areola if nipple protrusion was still evident postprocedure. The procedure is performed on an outpatient basis and did not require postoperative drain insertion. After the wound was dressed with gauze, a custom-made elastic vest was used immediately after surgery; the patient was advised to wear the vest for at least 1 month. Results: At the 1-month postoperative follow-up examination, patients were given a questionnaire pertaining to their satisfaction with (1) the appearance of the scar and (2) postoperative chest wall contour and (3) any improvement in self-confidence. Patients were asked to rate their satisfaction with the procedure on a scale from 1 to 10, with 10 being the most satisfied. The average rating was 9 and above for all three questions. Conclusion: We conclude that WAL liposuction combined with a limited pull-through technique underneath the areola can effectively manage grade I and II gynecomastia categorized by Rohrich classification.

並列關鍵字

gynecomastia ； water-jet assisted ； liposuction