• Medicine · Jun 2021

    Case Reports

    Surgical management of complicated gynecomastia (associated with foreign body injection) with single-port 3-dimensional videoscope-assisted endoscopic subcutaneous mastectomy and concurrent liposuction: A case report.

    • Tzu-Cheng Wen, Hung-Wen Lai, Chi Wei Mok, Shou-Tung Chen, Dar-Ren Chen, and Shou-Jen Kuo.
    • Endoscopy & Oncoplastic Breast Surgery Center, Changhua Christian Hospital, Changhua.
    • Medicine (Baltimore). 2021 Jun 4; 100 (22): e25962e25962.

    RationaleGynecomastia is a common benign breast disorder in men. Surgical management of gynecomastia includes that of a subcutaneous mastectomy with or without concurrent liposuction. Herein, the authors presented a case of complicated gynecomastia (gynecomastia with concurrent foreign body injection) which was successfully managed with an innovative technique that offered acceptable operative time, minimal complications, good recovery and satisfactory aesthetic outcome.Patient ConcernsA 39-year-old Taiwanese man who developed gynecomastia along with self-injection of foreign body (salad oil) over the past 10 years for breast enlargement presented as symptomatic bilateral breast lumps.DiagnosisBedside sonography revealed multiple large droplets of oil in the subcutaneous tissue bilaterally, resembling cystic lesions.InterventionBilateral single-port 3-dimensional videoscope-assisted endoscopic subcutaneous mastectomy was performed after bilateral breast liposuction. Operative findings include bilateral gynecomastia and previous bilateral breast foreign body material. The total weight of lipoaspirate was 400 grams and 300 grams for right and left side respectively. Subcutaneous mastectomy specimen weight was 820 grams and 661 grams for right and left breast tissue.OutcomesOperative duration was 315 minutes and intraoperative blood loss at 150 ml. Patient was discharged 2 days after the operation, and subsequent follow up ultrasound showed complete removal of foreign bodies and fibrotic breast tissue. Patient was satisfied with the post-operative aesthetic outcomes.LessonsSingle-port 3-dimensional videoscope-assisted endoscopic subcutaneous mastectomy with concurrent liposuction is a promising and safe surgical option for patient with complicated gynecomastia and severe fibrosis.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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