Hydrodynamic-Assisted Liposuction With Stab-Flatten Technique Versus Traditional Excision for Gynecomastia

BACKGROUNDTraditional combined surgery for moderate to severe gynecomastia (Simon Grade IIb–III) often results in significant trauma, visible scarring, and contour irregularity.

OBJECTIVETo compare outcomes between traditional liposuction/excision (Group A) and a minimally invasive approach using hydrodynamic-assisted liposuction with a stab-flatten technique (Group B).

METHODSA retrospective cohort study analyzed 112 patients (214 breasts) treated between 2023 and 2025. Group A (n = 50) underwent traditional liposuction and periareolar excision. Group B (n = 62) received the novel minimally invasive technique. Evaluation was based on the Breast Evaluation Questionnaire (BEQ), operative time, and complications.

RESULTSGroup B showed significantly superior BEQ scores for chest appearance, body image, satisfaction, and breast firmness. Operative duration was shorter in Group B. The incidence of postoperative complications, including nipple-areolar complex depression, hematoma, sensory abnormality, and scarring, was slightly lower in Group B.

CONCLUSIONThe hydrodynamic-assisted liposuction with stab-flatten technique is a safe, effective, and minimally invasive option. It is associated with improved breast contour, reduced scarring, and enhances patient-reported outcomes for moderate to severe gynecomastia.

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