الفهرس 
EMBRYOLOGYOnly 14 pages are availabe for public view
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Abstract
Gynecomastia is a male disorder characterized by breast enlargement due to gland augmentation associated with or without fat accumulation. Treatment of gynecomastia should be individualized according to the patient’s needs expectations as well as the specific indication for surgery. Medical treatment can be used early in the course of gynecomastia.
Surgical correction is considered “the gold standard therapy”; however, the choice of an adequate surgical technique selection is still challenging. The common aim is to obtain a male looking chest wall while minimizing residual scars. Yet, there are no clean gynecomastia surgical treatment. Gynecomastia present for more than 1 year is unlikely to regress spontaneously so surgery remains the mainstay of treatment. Webster in 1946, described an operation with a semicircular intra-areolar incision, which has become the standard operation for excision of gynecomastia. Over the following years numerous approaches were described.
Nowadays surgical treatment of gynecomastia can make use of different techniques like suction assisted lipoplasty or ultrasound assisted liposuction, and the endoscopic approach, or some combination of these methods have made it possible to reduce the invasiveness of the operation, improving the final result and reducing the scars. The shift towards a gynecomastia solution with less visible scarring and subsequent decrease downtime and a more optimal aesthetic appearance has forced plastic surgeons to look for new approaches.
Twenty patients with mild and moderate gynecomastia with age ranging between 23 and 39 were treated with Laser Assisted Liposuction combined with surgical excision. The results showed great success after subjective and objective evaluation. This was done by measuring the chest circumference in all cases pre and 6 months postoperatively and by giving the patient the chance to evaluate the result of his operation. In addition; experts were allowed to evaluate the photographs pre and 6 months postoperatively. Regarding the complications; some complications as hematoma and seroma were diminished. Laser assisted Lipolysis added the advantage of skin tightening and less bleeding to the procedure, surgical excision by semicircular periareolar incision also added other advantages to the maneuver as the glandular tissue is removed completely which prevents undercorrection present in suction-only procedures. The periareolar incison made the scar not well defined as it became camouflaged by the colour change between normal skin and areola. The procedure also made recovery time short and patients can quickly resume their normal activities, making the procedure rewarding for both the surgeon and the patient.
LAL for gynecomastia is safe, and produces significant effects on fatty tissue with a reduction in volume of the breast, together with gland excision. The result is significant and consistent. The advantage of LAL over ultrasonic and traditional liposuction is the good skin contraction and good skin tone that follows the procedure.