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LASER-ASSISTED LIPOSUCTION AND SUTURE SUSPENSION OF FLAP TECHNIQUE
FOR THE TREATMENT OF GYNECOMASTIA
Daniel Man, MD*; Vinod Podichetty, MD,MS
Dr. Man Aesthetic Surgery Center, Boca Raton, FL 33486. USA
SUMMARY
Gynecomastia has considerable impact on patient’s quality of life, estimated in 65% of normal adolescents.
The objective is to study laser assisted liposuction (LAL) and suture suspension of the sagging flap procedure without skin
excision as a superior technique for most forms of gynecomastia.
The study technique involved the use of 1064nm and 1444nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser with 400
µm fiber (Lutronic Inc., NJ) assisted liposuction to remove fatty breast tissue.
We conclude that combining laser assisted liposuction with suture suspension of flap technique has proven to correct all
grades of gynecomastia with less morbidity, inconspicuous scar and uniformly excellent aesthetic results
BACKGROUND
STUDY DESIGN and METHODS
 Gynecomastia has considerable impact on patient’s quality of life,
estimated in 65% of normal adolescents.
 This technique involved the use of 1064nm and 1444nm
neodymium:yttrium-aluminum-garnet (Nd:YAG) laser with 400 µm fiber
(Lutronic Inc., NJ) assisted liposuction to remove fatty breast tissue.
 Treatment is preferably surgical, whether it results from glandular
hypertrophy, fat accumulation or both.
 Of the wide range of surgical liposuction techniques currently in use, there
is disagreement on the most favorable option for different grades of
gynecomastia.
 Twelve men (ages 20 to 64 years) were treated between January 2008
and October 2008 for grade I (n=4), II (n=4), III (n=1) or IV (n=3)
gynecomastia.
 Surgical data, patient satisfaction and cosmetic outcome at 3-month
follow-up were analyzed.
OBJECTIVES
We studied laser assisted liposuction (LAL) and suture suspension of the
sagging flap procedure without skin excision as a superior technique for
most forms of gynecomastia.
AccuSculpt
Lutronics Inc.
RESULTS
 Twelve patients (24 breasts) were successfully treated using LAL.
 Patients (n=4) corrected using 1444nm Laser showed better results in fat removal and operative time than patients (n=8) treated with 1064nm.
 The average liquefied breast tissue aspirated was 820cc (range, 150 to 2700cc).
 4 patients (two in each group) had seroma and hematoma as complications. 1064nm used in one patient required a revision surgery.
 Since gynecomastia causes significant emotional distress and embarrassment, we conducted a two-mode outcome analysis.
 At three months, 85.5% of all patients were ‘satisfied’ to ‘very satisfied’ using a 5-point Likert score.
 Cosmetic outcome for shape, symmetry and scar appearance measured on standardized photographs scored ‘excellent’ in 11 of the 12 patients.
PRE - OPERATIVE
POST-OPERATIVE
PRE - OPERATIVE
POST - OPERATIVE
CONCLUSIONS
• Since the introduction of 1064 and 1444nm
Lasers, the technique has been successfully
used to treat gynecomastia patients.
• Combining laser assisted liposuction with
suture suspension of flap technique has proven
to correct all grades of gynecomastia with less
morbidity, inconspicuous scar and uniformly
excellent aesthetic results