Circumareolar Skin Reduction versus Long Scar in Surgical Treatment of High-Grade Gynecomastia

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Objective: The objective of this study was to compare the surgical treatment of gynecomastia using circumareolar excision versus transverse skin excision.

Methods: Thirty-six male patients with unilateral or bilateral gynecomastia participated in this prospective randomized study at our institution. Participants were divided into two groups: Group A received circumareolar skin excision, and group B received transverse skin excision. Patients were evaluated for surgical and postoperative complications, patient satisfaction, and cosmetic outcomes.

Results: There were no intraoperative complications or blood transfusions. The average operative time was 150 minutes for group A and 110 minutes for group B. Hospital stays ranged from one to two days. Both groups had a 5.56% incidence of hemostasis-related issues and wound infections. Seromas appeared in 11.11% of cases and resolved spontaneously. Wound dehiscence was observed in 16.67% of group A and 5.56% of group B, with no statistically significant difference. Hypertrophic scars occurred in 16.67% of group B, while none were reported in group A (p = 0.07).

Conclusions: The circumareolar technique requires longer surgical time and may lead to a less optimal chest contour. However, it provides superior cosmetic results for the nipple-areola complex. Both techniques demonstrate comparable rates of postoperative complications.