Incidence of Complications for Different Approaches in Gynecomastia Correction: A Systematic Review
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- Category: Vol. 92, December 2024
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Incidence of Complications for Different Approaches in Gynecomastia Correction: A Systematic Review, MOHAMMED A.M. NADA, MOHAMMED H. SHEHAB, KARIM FAHMY and DINA M. HANAFY
Abstract Background: The enlargement of breast tissue in males, is a common condition that can cause physical and psychologi-cal distress. Surgical correction is often sought to address this issue, and various approaches are employed by General and Plastic surgeons to achieve optimal results. The incidence of complications associated with different surgical approaches in gynecomastia correction varies, and understanding these var-iations is crucial for both patients and medical professionals. Aim of Study: To assess and compare the incidence of complications associated with different surgical approaches in gynecomastia correction. By synthesizing the existing body of literature, our goal is to provide a nuanced understanding of the safety profiles of various techniques, including liposuction, glandular excision, and combination methods, thereby offering valuable insights to clinicians involved in the management of gynecomastia. Material and Methods: The type of study being conduct-ed is a systematic reviewfocuses on gynecomastia correction and aims to provide a consolidated and evidence-based under-standing of the incidence and types of complications associ-ated with different surgical approaches, including liposuction, glandular excision, and combination techniques. The review follows a structured and transparent methodology, adhering to established guidelinessuch as the Preferred Reporting Items for Systematic Reviews to ensure the reliability and validity of the findings. Results: The analysis of gynecomastia correction tech-niques across 94 studies highlights varying complication rates among glandular excision, liposuction, and combination meth-ods. Glandular excision, associated with the highest compli-cation rate, frequently results in hematoma, seroma, infection, and necrosis. Liposuction, generally safer, mostly reports minor complications like seroma and numbness. Combination meth-ods aim to reduce risks but still show hematoma, seroma, and wound dehiscence. Age-wise distribution reveals most proce-dures in the 20-29 age group, with significant numbers also in the 10-19 range. Complications in glandular excision are high-est (860 out of 2,882 patients), while liposuction reports the fewest (144 out of 904 patients), and combination techniques show intermediate complications (403 out of 3,506 patients), with a significant p-value (<0.001). Breast pathologies, cate-gorized by age and type (unilateral, bilateral, synchronous), indicate that conditions like ADH, DCIS, and mastopathy are common in younger to middle-aged groups, while older groups (80-89) show diverse pathologies, including invasive carcino-ma and bilateral complications. This data underscores the need for careful patient selection and tailored surgical approaches to mitigate risks and improve outcomes. Conclusion: The analysis of complications associated with gynecomastia correction techniques and the distribution of breast pathologies across age groups provides critical insights into the safety and risk profiles of surgical interventions. Glan-dular excision, while effective, shows a higher incidence of complications compared to liposuction and combination tech-niques, emphasizing the need for careful patient selection and surgical expertise. Younger age groups, particularly those be-tween 10 and 29 years, exhibit a higher frequency of procedures and complications like atypical ductal hyperplasia and masto-pathy. In contrast, older age groups, especially those above 60, demonstrate a notable presence of invasive carcinoma and bi-lateral mastopathy. These findings underscore the importance of tailored surgical approaches and vigilant monitoring for complications, aiming to optimize patient outcomes and guide future research in gynecomastia correction and breast patholo-gy management.