Robert S. Hamas, MD and Cholm W. Williams, MBBS

Gynecomastia can have an adverse effect on body image, causing some men to seek treatment. Direct excision alone may be avoided because of scars and the potential for contour irregularity, hematoma, and seroma formation. Typical blunt liposuction cannulas can remove fat from breasts that are not very fibrous, but they are not useful for removal of the fibrous breast tissue core, which then requires open excision.

Ultrasound-assisted lipoplasty (UAL) has been used for gynecomastia because it penetrates fibrous tissue to remove fat, but there is no report of how much fibrous breast tissue is actually removed by the applied ultrasound energy. The finding of increased mammogram density after UAL strongly suggests limited fibrous tissue removal. Compared with liposuction, UAL requires larger incisions and costly equipment and has risks of seroma and skin burns.

As an alternative to blunt cannulas and UAL, a liposuction cannula was designed with(1) a tip that is sharp and pointed so it is very easy to push into fibrous breast tissue and (2) edges of the openings that are sharpened to cut strips of fibrous tissue and breast tissue as the cannula slides back and forth. Sharp cutting liposuction cannulas can effectively remove fibrous breast tissue along with fat in the treatment of gynecomastia.

A 45-year-old patient. A Preoperative, B Postoperative at 12 months.

Dr. Hamas is in private plastic surgery practice in Dallas, TX. Dr. Williams is in private plastic surgery practice in Sydney, Australia.

The authors designed the sharp cutting cannula but have no financial interest in it.