Transaxillary Suspension Endoscopic-Assisted Subcutaneous Gland Excision - Clinical Outcomes and Significance in Gynecomastia Management

Q: What surgical techniques were compared for gynecomastia management?

The study compared a lipolysis-free suspension endoscopic-assisted subcutaneous mastectomy (observation group) with a conventional subcutaneous mastectomy via midaxillary incision (control group). Both targeted treatment for male gynecomastia.

Q: What perioperative benefits did the suspension endoscopic approach provide?

Compared with the conventional open approach, the endoscopic suspension technique significantly reduced intraoperative blood loss, postoperative drainage volume, and drainage duration, although operative time was longer.

Q: Did the new technique change complications, satisfaction, and psychological outcomes?

Complication rates, including nipple-areola necrosis and postoperative bleeding, did not differ significantly. Patient-reported satisfaction was higher across multiple aesthetic domains, and psychological assessment showed greater improvement in interpersonal sensitivity, with no significant differences for obsessive-compulsive or depression-anxiety symptoms.

Sep 29, 2026

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Transaxillary suspension endoscopic-assisted subcutaneous mastectomy is evaluated as a novel, pneumoperitoneum-free approach for gynecomastia management. A single-center, non-randomized retrospective comparison enrolled 103 male patients treated from January 2021 to March 2024, contrasting a lipolysis-free suspension endoscopic technique (n=43) with conventional midaxillary subcutaneous mastectomy (n=60). Outcomes showed lower intraoperative blood loss, reduced postoperative drainage volume, and shorter drainage duration, with longer operative time. Complication and psych symptom profiles were largely comparable, while satisfaction and interpersonal sensitivity improved more with the endoscopic approach.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Introduction

Background

What is known and what is new?

Highlight box

Key findings

Methods

Study design and participants

Endpoints

Results

Perioperative outcomes

Complications

Satisfaction and psychological assessments

Conclusions

Transaxillary suspension endoscopic-assisted subcutaneous gland excision: clinical outcomes and significance in gynecomastia management Jiaqi Liu, Xufang Sui, Jun Chu Department of Breast and Thyroid Surgery, Zibo Central Hospital, Zibo, China Contributions: (I) Conception and design: All authors; (II) Administrative support: None; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: All authors; (V) Data analysis and interpretation: J Liu, X Sui; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Jun Chu, Master’s degree. Department of Breast and Thyroid Surgery, Zibo Central Hospital, No. 54 Gongqingtuan Road, Zhangdian District, Zibo 255000, [China. Email: junchu_dr@163.com](China. Email: junchu_dr@163.com). Background: Gynecomastia (GM) is the most common male breast condition, often leading to psychological distress despite its benign nature. Surgical treatment is typically required for moderate to severe cases. Traditional subcutaneous mastectomy via midaxillary incision, while cosmetically concealed, may increase the risk of bleeding due to limited access. Endoscopic-assisted approaches offer better cosmetic and recovery outcomes but often require pneumoperitoneum, which carries physiological risks. To address these issues, a novel suspension endoscopic-assisted technique without pneumoperitoneum has been developed. This study aims to evaluate its safety, efficacy, and aesthetic outcomes compared to the conventional open approach. Methods: This single-center, non-randomized, retrospective comparative study analyzed 103 male patients with GM who underwent surgical treatment between January 2021 and March 2024. Patients were divided into two groups: 43 underwent lipolysis-free suspension endoscopic-assisted subcutaneous mastectomy (observation group), while 60 received conventional subcutaneous mastectomy via midaxillary incision (control group) . Primary endpoints included perioperative parameters and complications. Secondary endpoints comprised a composite patient-reported satisfaction score assessed at the 180-day followup. Psychological parameters were evaluated using instruments at baseline and postoperatively to assess treatment-related psychological improvements. Results: Baseline demographic characteristics were comparable between the two groups (P>0.05) . The observation group demonstrated significantly reduced intraoperative blood loss [32.00 (27.00–43.00) vs. 57.00 (41.00–65.00) mL; P<0.001], lower postoperative drainage volume [27.00 (24.50–30.00) vs. 35.12 (33.00–37.50) mL; P<0.001], and shorter drain duration [3.00 (3.00–3.00) vs. 4.00 (4.00–5.00) days; P<0.001], albeit with longer operative time [123.00 (109.00–135.00) vs. 35.00 (32.00–37.00) min; P<0.001] . Complication rates, including nipple-areola necrosis and postoperative bleeding, did not differ significantly between groups (P>0.05) . Patient satisfaction scores were consistently higher in the observation group across multiple domains: self-perception (P<0.001), skin incision appearance (P<0.001), and bilateral symmetry (P<0.001). Nipple sensation was also slightly better (P=0.011) . Psychological assessments revealed greater postoperative improvement in interpersonal sensitivity in the observation group (P<0.001), with no significant group differences in obsessive-compulsive or depression-anxiety symptoms. Conclusions: This retrospective study demonstrated that transaxillary suspension endoscopic-assisted subcutaneous mastectomy significantly reduced intraoperative blood loss, postoperative drainage volume, and drainage duration, albeit with a longer operative time. While the incidence of postoperative complications was comparable between groups, the endoscopic approach was associated with significantly higher patientreported satisfaction across multiple aesthetic domains and yielded greater improvement in postoperative p

FAQs

What surgical techniques were compared for gynecomastia management?

The study compared a lipolysis-free suspension endoscopic-assisted subcutaneous mastectomy (observation group) with a conventional subcutaneous mastectomy via midaxillary incision (control group). Both targeted treatment for male gynecomastia.

What perioperative benefits did the suspension endoscopic approach provide?

Compared with the conventional open approach, the endoscopic suspension technique significantly reduced intraoperative blood loss, postoperative drainage volume, and drainage duration, although operative time was longer.

Did the new technique change complications, satisfaction, and psychological outcomes?

Complication rates, including nipple-areola necrosis and postoperative bleeding, did not differ significantly. Patient-reported satisfaction was higher across multiple aesthetic domains, and psychological assessment showed greater improvement in interpersonal sensitivity, with no significant differences for obsessive-compulsive or depression-anxiety symptoms.

Sep 29, 2026

Uploaded by นรินทร์