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Original Research Article

Year: 2020 | Month: October | Volume: 7 | Issue: 10 | Pages: 201-218

A Study of Fat: Gland Ratio as an Indicator for Predicting Appropriate Surgical Modality in Gynaecomastia

Meheraj SK¹,Naveen Kumar², Shyam Gupta³

¹Senior Resident, Department of Plastic & Reconstructive Surgery, IPGMER & SSKM Hospital, Kolkata -700020.
²Assistant Professor, Department of Plastic Surgery, Lady Hardinge Medical College and Associated Hospital, New Delhi -110001.
³Plastic Surgery Consultant, Gwalior.

Corresponding Author: Naveen Kumar

ABSTRACT

Introduction: Gynecomastia is the commonest condition of male breast in male population. A number of diagnostic modalities are in use nowadays with each having its indications. Diagnosis of gynecomastia is usually evident with clinical examination but the different proportions of gynecomastia are difficult to assess clinically. Current protocol of gynecomastia in lower grades is to start with liposuction and assessment of breast after finishing liposuction. If any residual lump felt then excision done. So there is always an uncertainty in preoperative planning. A number of studies are available about the excisional and liposuction techniques but very little written about the quantitative estimation of fat and gland volume. Materials and Methods: We utilized ultrasonography to assess gland volume and Anthropometric method to obtain breast volume and both were used to decide the appropriate surgical modality preoperatively. Results: Gland volume obtained by ultrasound was different in two study groups with p value being 0.05 suggesting its significance. Similarly breast volume obtained by anthropometry was different in two groups with p value<0.05. There was found strong positive correlation between gland volume and breast volume as the breast size increase. Cut off value of gland volume 5.5cc and breast volume 250 cc can be used to predict excision or liposuction followed by excision. Fat/ Gland ratio was not found significant. Conclusion: We recommend this method to be used routinely to predict the appropriate surgical modality. We present a grading system of gynecomastia and treatment algorithm on the basis of gland volume and breast volume.

Keywords: Gynecomastia, Breast, Volume, Liposuction , Gland, Excision

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