The Outcomes of the Passot Technique in the Surgical Treatment of Severe Gynecomastia

Background: Gynecomastia is a benign enlargement of the male breast that may cause physical discomfort and psychological distress. The Passot technique offers an alternative approach with inconspicuous inframammary scars and reliable outcomes in severe cases. This study aimed to evaluate the aesthetic outcomes, patient satisfaction, and complications following the surgical treatment of severe gynecomastia using the Passot technique. Methods: At Zagazig University Hospitals' Plastic and Reconstructive Surgery Department, 18 male patients with Simon grade IIb and III gynecomastia participated in this prospective clinical trial. All patients underwent the Passot technique with gland excision and liposuction. Postoperative follow-up was performed at 1 week, 3 weeks, 1 month, 3 months, and 6 months. Outcomes were assessed subjectively (patient satisfaction) and objectively (aesthetic evaluation and complications). Results: The mean age of patients was 33±7.1 years, and the mean BMI was 36.05±7.9kg/m². Aesthetic evaluation showed good results in 83.3% of cases, excellent results in 11.1%, and fair results in 5.6%. All patients reported good objective and subjective satisfaction. The most common early complication was scarring (61.1%), followed by seroma (16.7%) and wound dehiscence (11.1%), while hematoma and wound infection occurred in only 5.6% of cases. Late complications included hypertrophic/hypotrophic scars, residual dog-ear deformities, and partial nipple–areola necrosis (11.1% each). A significant negative correlation was found between BMI and aesthetic outcome (p=0.01). Conclusion: The Passot technique is a safe and effective option for managing severe gynecomastia, providing high satisfaction rates and favorable aesthetic outcomes with acceptable complication rates.