Pseudogynecomastia after Massive Weight Loss: Detectability of Technique, Patient Satisfaction, and Classification

被引:37
作者
Gusenoff, Jeffrey A. [1 ]
Coon, Devin [1 ]
Rubin, J. Peter [1 ]
机构
[1] Univ Pittsburgh, Med Ctr, Div Plast & Reconstruct Surg, Life Weight Loss Ctr, Pittsburgh, PA 15261 USA
关键词
D O I
10.1097/PRS.0b013e3181881df4
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: An increasing number of male patients are presenting for treatment of male chest deformity after massive weight loss. The authors prefer to preserve the nipple-areola complex on a dermoglandular pedicle. They sought to identify detectability of technique, assess patient satisfaction, and outline a treatment algorithm for this population. Methods: Ten male massive weight loss patients underwent chest-contouring procedures over a period of 6 years and were surveyed to identify satisfaction with reconstruction. Preoperative photographs were used to devise a classification system. Twenty-seven medical professionals evaluated and rated digital photographs of the patients. Results: Eight patients had pedicled reconstructions and two had free-nipple grafts. Mean age was 42.9 +/- 9.5 years, mean pre-weight loss body mass index was 54.1 +/- 10.6, post-weight loss body mass index was 29.4 +/- 4.5, and mean change in body mass index was 24.8 +/- 9.7. All patients would have surgery again, nine would recommend it to a friend, six would go shirtless in public, nine reported no loss of nipple sensation, and three reported dysesthesias of the nipple-areola complex. Medical professionals reproducibly associated poor wound healing with free-nipple grafting and rated poorly positioned nipple-areola complexes with low aesthetic scores. Medical professional scores for chest contour and nipple-areola complex aesthetics did not correlate with technique and were lower than scores provided by the patients. Conclusions: Patient satisfaction for treatment of the male chest deformity after massive weight loss is high. In carefully selected patients, preservation of the nipple-areola complex on a dermoglandular pedicle can aid in achieving an optimal aesthetic result. (Plast. Reconstr. Surg. 122: 1301, 2008.)
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页码:1301 / 1311
页数:11
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