Peri-areolar double-pedicle technique in the treatment of iatrogenic gynecomastia

Objectives: To describe the surgical approach to the treatment of iatrogenic gynecomastia via peri-areolar incision. Methods: In this study, we describe our experience in the surgical management of iatrogenic hormonal gynecomastia with our technique described for idiopathic gynecomastia. We treated 70 patients with gynecomastia at a plastic surgery unit between 2000 and 2016. Ten of these patients had a painful hypertrophic mammary gland with grade III gynecomastia secondary to hormone therapy after prostate cancer. Results: The presence of a very discreet scar around the areola often has very interesting aesthetic results. Areolar tissue sensation was completely preserved in 40% of patients. No short-term complications were observed; in follow-up, only one case of keloid scars was noted on a patient with dark skin, and only one case of areolar necrosis on a patient with critical breast ptosis. Conclusion: This technique is feasible. It restores almost normal anatomy structure with minimal scarring and preserves good regional neurovascular supply, with only 60% altered areolar sensation.