Exclusive liposuction with glandular tissue redistribution for severe gynecomastia: A case report

Abstract

Rationale: Gynecomastia, characterized by abnormal enlargement of male breast tissue, can lead to significant psychological distress, particularly among younger men. Traditional surgical options, such as subcutaneous mastectomy and liposuction, often result in visible scarring and contour deformities. This study introduces the "Stab Flatten" technique, a novel, minimally invasive approach for treating severe gynecomastia, designed to preserve chest aesthetics while minimizing postoperative complications, including scarring and contour irregularities.

Patient concerns: A 28-year-old male with a 15-year history of progressive bilateral breast enlargement presented with psychological distress and concerns about the cosmetic outcomes of traditional surgery. He sought a minimally invasive procedure to address both physical discomfort and aesthetic concerns, aiming for minimal scarring.

Diagnoses: The patient was diagnosed with grade III gynecomastia according to Simon classification, characterized by significant glandular hypertrophy and excess skin. Diagnostic imaging and laboratory tests confirmed the absence of underlying medical conditions.

Interventions: The patient underwent the "Stab Flatten" technique, which involved exclusive liposuction with glandular tissue redistribution. A 4-mm incision was made at the inframammary crease, and power-assisted liposuction was used to flatten fibroglandular tissue without excision. Postoperative care included a compression garment for 6 months.

Outcomes: At the 6-month follow-up, the patient showed excellent cosmetic results, with significant improvement in breast contour and symmetry. There were no complications such as hematoma, seroma, or nipple-areola complex deformities. The patient reported high satisfaction with the aesthetic outcome, alongside improved psychological well-being and physical comfort.

Limitations: This study is limited by its single-patient case report, which restricts the generalizability of the findings. Long-term outcomes of the "Stab Flatten" technique require further validation through larger, prospective studies with more diverse patient populations. Additionally, the technique may not be applicable to all grades of gynecomastia or patients with more complex conditions.

Lessons: The "Stab Flatten" technique offers an effective, minimally invasive alternative for treating severe gynecomastia, providing excellent cosmetic and functional outcomes while minimizing scarring. This method may enhance patient satisfaction and reduce recovery times compared to traditional surgical approaches. However, further studies with larger cohorts are necessary to validate its efficacy and generalizability.

Figure 1.

Preoperative photograph of a 28-year-old patient with grade III gynecomastia, demonstrating severe breast enlargement with pronounced glandular tissue hypertrophy and significant ptosis. The patient’s chest contour is notably distorted, with excessive subcutaneous adipose deposition and stretched overlying skin. This presentation exemplifies the advanced stage of gynecomastia, which often requires surgical intervention due to the significant physical and psychological burden imposed by the condition. Preoperative images captured from 5 different angles (A–E).

Figure 2.

Postoperative images at 3 months following surgical correction of grade III gynecomastia using the “Stab Flatten” technique, captured from 3 different angles (A–C). The images show significant improvement in chest contour, with effective reduction of both glandular tissue and adipose volume. Skin retraction is well-aligned, and the natural masculine chest appearance has been restored.

Figure 3.

Postoperative photographs taken 6 months after surgery using the “Stab Flatten” technique, viewed from 3 different angles (A–C), showing significant improvement in chest contour and overall appearance. The procedure effectively reduced breast volume, achieving a smooth and natural result. The skin has retracted well, with minimal scarring, which is virtually imperceptible, reflecting the success of the “Stab Flatten” method in delivering both functional and aesthetic benefits.