Comparison of Clinical Outcomes Between Liposuction Combined with the Pull-Through Technique Versus Arthroscopic Shaver Excision for Gynecomastia

BACKGROUND: Gynecomastia, a benign proliferation of mammary gland tissue in males, negatively affects body image and can cause psychological distress. Surgical treatments such as subcutaneous mastectomy and liposuction are common but may result in complications like scarring and hematoma. The arthroscopic shaver, originally used for varicose vein and arthroscopic surgeries, has shown promise for soft tissue removal. This study compares the outcomes of liposuction combined with the pull-through technique and the arthroscopic shaver in gynecomastia treatment. METHODS: Patients with gynecomastia and received surgical treatment were enrolled in the study retrospectively. One group of patients underwent liposuction after tumescent solution infiltration into the breast tissue and pull-through technique to remove residual breast glands through a single periareolar incision. The other group of patients underwent breast tissue removal using the arthroscopic shaver. Comparison of postoperative complications was made between the two groups. RESULTS: Among the enrolled patients, 20 patients underwent the pull-through technique with liposuction and 31 patients underwent arthroscopic shaver treatment. Common complications such as hematoma, ecchymosis, and residual irregular fat were not observed in the pull-though group, while higher rates of hematoma and ecchymosis were reported in the arthroscopic shaver group. The liposuction amount showed no significant difference between patients with versus without hematoma or ecchymosis. CONCLUSIONS: The pull-through technique with liposuction provides excellent results for gynecomastia treatment with minimal complications. The arthroscopic shaver is also effective but associated with higher rates of hematoma and ecchymosis, requiring greater postoperative vigilance. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .