Modified Benelli procedure for subcutaneous mastectomy in gynecomastia: A randomised controlled trial

Background: Gynecomastia is defined as a benign glandular proliferation of the male breast tissue causing enlargement of the breast and a feminine appearance. Gynecomastia is usually treated surgically in some patients by different techniques. Aim of the study: is to allow ample excess during excision and to remove excess skin to allow for better cosmetic results using "modified Benelli technique" and to obtain good breast shape with better nipple areola complex position without any breast tension. Type of the study: Randomised controlled trial study. Patients and methods: The study included 150 patients with gynecomastia (Grade II and III) for the period between January 2010 and January 2016 who attended private hospitals and Al-Kindy Teaching Hospital. The patients were divided into two groups according to the operative techniques used. Group A included 75 patients treated surgically with subcutaneous mastectomy using periareolar incision. Group B; included the other 75 patients who were managed by "modified Benelli technique". Results: The subcutaneous mastectomy using "modified Benelli technique" showed a significantly lower operating time due to ample access for excision of breast tissue. Excision of excess skin allowed the areola to retain a cosmetically more acceptable position. There was a lot of pleating of the skin compared to the other technique using the periareolar incision. Conclusions: This technique namely the "modified Benilli technique" provides a relatively simple method with an aesthetically good outcome to treat gynecomastia with a low rate of complications and recurrences.