Male Chest Athletic Definition: A Comprehensive View From an Anatomical and Physiological Perspective

Abstract Background Management of the male pectoral region to obtain a natural but athletic contour through liposuction is constantly changing, but no single method can avoid all long-term problems, such as gynecomastia with eventual loss of pectoral definition, fat graft asymmetry, and/or unnatural definition. Objectives The aim of this article was to describe a surgical technique to improve the male pectoral region through liposuction in specific areas, muscular volumization with objectively established fat volumes based on intracompartmental pressure measurements, and the management and prevention of gynecomastia. This approach aims to ensure the maximal survival of the fat graft with reduced fat necrosis and long-term asymmetry, producing sustained results over time. Methods Measurement of pectoralis major pressure after fat grafting was conducted in 150 patients (19-60 years old; BMI < 30 kg/m2) between January 2021 and June 2023. Results The 2 models used in this study exhibited strong explanatory power, indicating that a significant portion of the variability in fat graft resorption could be explained by the variables included in these models. Postoperative exercise, patient age, and intramuscular pressure of the transferred fat showed statistically significant correlation with fat graft survival. BMI did not show a statistically significant relationship. The established volumes did not exceed 8 mm Hg intracompartmental pressure. Higher volumes reduced fat survival. Large volumes led to greater postoperative asymmetry and loss of fat grafts. Conclusions This technique can treat and prevent gynecomastia while simultaneously improving the appearance of the male chest through volumization of the pectoralis major with safe fat graft volumes. Level of Evidence: 4 (Therapeutic)