{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:51:03Z","timestamp":1787320263452,"version":"build-2736575974"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gynecomastia, a common condition involving benign breast tissue enlargement in men, poses challenges for plastic surgeons, especially in severe cases. Current surgical methods for severe gynecomastia often require complex, invasive procedures with skin resection, resulting in significant scarring. Conversely, techniques avoiding skin resection frequently leave skin redundancy and an unsatisfied chest contour.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The authors of this study introduce a skin redistribution and fixation approach, which help to improve aesthetic outcomes and eliminate the need for skin excision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The surgical procedure comprised 4 stages: an initial liposuction, a mastectomy, a subsequent liposuction session, and an approach for the redistribution and fixation of skin. Liposuction was extended across the breasts, chest wall, and lateral chest wall. Subcutaneous mastectomy was performed through small infraareolar incisions. The redistribution and fixation approach involved 2 steps: surgeons manually distributed the loose and accumulated skin evenly across the chest, followed by the application of a sterile, self-adhesive foam dressing to secure the skin on each side of the chest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between July 2018 and January 2024, 77 patients with severe gynecomastia received treatment with skin redistribution and fixation, whereas 73 underwent traditional liposuction and mastectomy. Follow-up periods ranged from 13\u2005months to 5 years. Patients received skin redistribution and fixation approach reported improved satisfaction regarding the final shape, contour, and symmetry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The skin redistribution and fixation approach could help to enhance aesthetic outcomes and achieve better chest contour in surgical treatment for severe gynecomastia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence: 4 (Therapeutic)<\/jats:title>\n                    <jats:p\/>\n                  <\/jats:sec>","DOI":"10.1093\/asj\/sjaf193","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T12:01:02Z","timestamp":1758801662000},"page":"260-268","source":"Crossref","is-referenced-by-count":1,"title":["Improving Surgical Treatment for Severe Gynecomastia and Avoiding Skin Resection: Skin Redistribution and Fixation Approach for Aesthetic Excellence"],"prefix":"10.1093","volume":"46","author":[{"given":"Wenshan","family":"Xing","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengyao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinlong","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"issue":"10","key":"2026030212064513000_sjaf193-B1","doi-asserted-by":"publisher","first-page":"3134","DOI":"10.1210\/clinem\/dgaa440","article-title":"Marked increase in incident gynecomastia: a 20-year national registry study, 1998 to 2017","volume":"105","author":"Koch","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"2026030212064513000_sjaf193-B2","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.bodyim.2015.08.004","article-title":"Gynecomastia and psychological functioning: a review of the literature","volume":"15","author":"Ordaz","year":"2015","journal-title":"Body Image"},{"key":"2026030212064513000_sjaf193-B3","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1016\/j.adolescence.2015.06.007","article-title":"A systematic review of literature on psychosocial aspects of gynecomastia in adolescents and young men","volume":"43","author":"Rew","year":"2015","journal-title":"J Adolesc"},{"key":"2026030212064513000_sjaf193-B4","doi-asserted-by":"publisher","first-page":"e1025","DOI":"10.1210\/clinem\/dgaa044","article-title":"Sex hormone profile in pubertal boys with gynecomastia and pseudogynecomastia","volume":"105","author":"Reinehr","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"2026030212064513000_sjaf193-B5","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1111\/tbj.13221","article-title":"The role of expression of estrogen and progesterone receptors in idiopathic gynecomastia etiology","volume":"25","author":"Kasielska-Trojan","year":"2019","journal-title":"Breast J"},{"key":"2026030212064513000_sjaf193-B6","doi-asserted-by":"publisher","first-page":"e13992","DOI":"10.1111\/and.13992","article-title":"Evaluation of pubertal and pathological gynaecomastia in children: a single-center experience","volume":"53","author":"Celebi Bitkin","year":"2021","journal-title":"Andrologia"},{"key":"2026030212064513000_sjaf193-B7","doi-asserted-by":"publisher","first-page":"e13962","DOI":"10.1111\/and.13962","article-title":"Biochemical features of eugonadal patients with idiopathic gynaecomastia: a retrospective cross-sectional study","volume":"53","author":"Vita","year":"2021","journal-title":"Andrologia"},{"key":"2026030212064513000_sjaf193-B8","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1007\/s00431-020-03799-x","article-title":"Prepubertal gynecomastia is not always idiopathic: case series and review of the literature","volume":"180","author":"Laimon","year":"2021","journal-title":"Eur J Pediatr"},{"key":"2026030212064513000_sjaf193-B9","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1097\/00006534-197301000-00009","article-title":"Classification and surgical correction of gynecomastia","volume":"51","author":"Simon","year":"1973","journal-title":"Plast Reconstr Surg"},{"key":"2026030212064513000_sjaf193-B10","doi-asserted-by":"publisher","first-page":"1222","DOI":"10.1007\/s00266-018-1118-x","article-title":"Evaluation of glandular liposculpture as a single treatment for grades I and II gynaecomastia","volume":"42","author":"Abdelrahman","year":"2018","journal-title":"Aesthetic Plast Surg"},{"key":"2026030212064513000_sjaf193-B11","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1007\/s00266-016-0749-z","article-title":"No-drain single incision liposuction pull-through technique for gynecomastia","volume":"41","author":"Khalil","year":"2017","journal-title":"Aesthetic Plast Surg"},{"key":"2026030212064513000_sjaf193-B12","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1016\/j.bjps.2019.09.003","article-title":"Review of the microdebrider excision and liposuction technique (MELT) for the treatment of gynecomastia","volume":"73","author":"Sim","year":"2020","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"2026030212064513000_sjaf193-B13","doi-asserted-by":"publisher","first-page":"1084","DOI":"10.1111\/tbj.13424","article-title":"Comparison of curative effects between mammotome-assisted minimally invasive resection (MAMIR) and traditional open surgery for gynecomastia in Chinese patients: a prospective clinical study","volume":"25","author":"Wang","year":"2019","journal-title":"Breast J"},{"key":"2026030212064513000_sjaf193-B14","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1007\/s00266-016-0705-y","article-title":"Surgical management of gynecomastia: subcutaneous mastectomy and liposuction","volume":"40","author":"Kim","year":"2016","journal-title":"Aesthetic Plast Surg"},{"key":"2026030212064513000_sjaf193-B15","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1007\/s00266-021-02520-z","article-title":"Liposuction assisted gynecomastia surgery with minimal periareolar incision: a systematic review","volume":"46","author":"Prasetyono","year":"2022","journal-title":"Aesthetic Plast Surg"},{"key":"2026030212064513000_sjaf193-B16","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.surg.2021.01.046","article-title":"Endoscopic subcutaneous mastectomy plus liposuction via a single axillary incision for gynecomastia in Asian patients: a report of 45 cases","volume":"170","author":"Yang","year":"2021","journal-title":"Surgery"},{"key":"2026030212064513000_sjaf193-B17","doi-asserted-by":"publisher","first-page":"2011","DOI":"10.1007\/s00266-019-01501-7","article-title":"Endoscopic axillary approach improves patient satisfaction of gynecomastia subcutaneous mastectomy: a cross-sectional study using the BODY-Q chest module","volume":"44","author":"Xu","year":"2020","journal-title":"Aesthetic Plast Surg"},{"key":"2026030212064513000_sjaf193-B18","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1007\/s00266-023-03727-y","article-title":"Treatment of gynecomastia by endoscopic subcutaneous mastectomy in adolescents","volume":"29","author":"Varlet","year":"2019","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"2026030212064513000_sjaf193-B19","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1097\/SAP.0000000000000940","article-title":"Management of gynecomastia in patients with different body types: considerations on 312 consecutive treated cases","volume":"78","author":"Innocenti","year":"2017","journal-title":"Ann Plast Surg"},{"key":"2026030212064513000_sjaf193-B20","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1186\/s12887-019-1887-7","article-title":"Combined surgical and medical treatment in an adolescent with severe gynecomastia due to excessive estradiol secretion: a case report","volume":"19","author":"Moon","year":"2019","journal-title":"BMC Pediatr"},{"key":"2026030212064513000_sjaf193-B21","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1016\/j.amjsurg.2018.01.035","article-title":"Changing practices: the addition of a novel surgical approach to gynecomastia","volume":"216","author":"Wyrick","year":"2018","journal-title":"Am J Surg"},{"key":"2026030212064513000_sjaf193-B22","doi-asserted-by":"publisher","first-page":"2118","DOI":"10.1007\/s00266-021-02275-7","article-title":"Gynecomastia and chest masculinization: an updated comprehensive reconstructive algorithm","volume":"45","author":"Innocenti","year":"2021","journal-title":"Aesthetic Plast Surg"},{"key":"2026030212064513000_sjaf193-B23","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1016\/j.bjps.2008.04.033","article-title":"Treatment of severe gynaecomastia (grade III) by Moufarrege technique","volume":"62","author":"Copcu","year":"2009","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"2026030212064513000_sjaf193-B24","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1097\/SAP.0000000000000229","article-title":"Severe gynecomastia: new technique using superior pedicle NAC flap through a circumareolar approach","volume":"76","author":"Ibrahiem","year":"2016","journal-title":"Ann Plast Surg"},{"key":"2026030212064513000_sjaf193-B25","doi-asserted-by":"publisher","first-page":"1506","DOI":"10.1007\/s00266-018-1232-9","article-title":"Treatment of severe gynecomastia after massive weight loss: analysis of long-term outcomes measured with the Italian version of the BODY-Q","volume":"42","author":"Barone","year":"2018","journal-title":"Aesthetic Plast Surg"},{"key":"2026030212064513000_sjaf193-B26","doi-asserted-by":"publisher","first-page":"2273","DOI":"10.1111\/j.1743-6109.2010.01721.x","article-title":"High grade gynecomastia: surgical correction and potential impact on erectile function","volume":"7","author":"El Noamani","year":"2010","journal-title":"J Sex Med"},{"key":"2026030212064513000_sjaf193-B27","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1007\/s00266-008-9278-8","article-title":"Surgical treatment of gynecomastia with severe ptosis: periareolar incision and dermal double areolar pedicle technique","volume":"33","author":"Cannistra","year":"2009","journal-title":"Aesthetic Plast Surg"},{"key":"2026030212064513000_sjaf193-B28","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1097\/01.sap.0000112347.30612.f4","article-title":"The surgical management of high-grade gynecomastia","volume":"53","author":"Tashkandi","year":"2004","journal-title":"Ann Plast Surg"},{"key":"2026030212064513000_sjaf193-B29","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1097\/00000658-194609000-00011","article-title":"Mastectomy for gynecomastia through a semicircular intra-areolar incision","volume":"124","author":"Webster","year":"1946","journal-title":"Ann Surg"},{"key":"2026030212064513000_sjaf193-B30","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1016\/S0094-1298(20)30875-0","article-title":"Gynecomastia. Liposuction and excision","volume":"18","author":"Mladick","year":"1991","journal-title":"Clin Plast Surg"},{"key":"2026030212064513000_sjaf193-B31","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1177\/145749690309200209","article-title":"Surgical treatment of gynecomastia: liposuction combined with subcutaneous mastectomy","volume":"92","author":"Boljanovic","year":"2003","journal-title":"Scand J Surg"},{"key":"2026030212064513000_sjaf193-B32","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1007\/s00266-019-01537-9","article-title":"External quilting: new technique to avoid haematoma in gynaecomastia surgery","volume":"44","author":"Murugesan","year":"2020","journal-title":"Aesthetic Plast Surg"},{"key":"2026030212064513000_sjaf193-B33","doi-asserted-by":"publisher","first-page":"904","DOI":"10.1097\/PRS.0000000000004807","article-title":"Defining the aesthetic units of the male chest and how they relate to gynecomastia based on 635 patients","volume":"142","author":"Caridi","year":"2018","journal-title":"Plast Reconstr Surg"},{"key":"2026030212064513000_sjaf193-B34","doi-asserted-by":"publisher","first-page":"e4256","DOI":"10.1097\/GOX.0000000000004256","article-title":"Total gynecomastia removal with layered closure: a study of 567 cases","volume":"10","author":"Caridi","year":"2022","journal-title":"Plast Reconstr Surg Glob Open"}],"container-title":["Aesthetic Surgery Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/asj\/advance-article-pdf\/doi\/10.1093\/asj\/sjaf193\/64414808\/sjaf193.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/asj\/article-pdf\/46\/3\/260\/64414808\/sjaf193.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/asj\/article-pdf\/46\/3\/260\/64414808\/sjaf193.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T17:06:53Z","timestamp":1772471213000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/asj\/article\/46\/3\/260\/8266329"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,26]]},"references-count":34,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,9,26]]},"published-print":{"date-parts":[[2026,3,2]]}},"URL":"https:\/\/doi.org\/10.1093\/asj\/sjaf193","relation":{},"ISSN":["1090-820X","1527-330X"],"issn-type":[{"value":"1090-820X","type":"print"},{"value":"1527-330X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2025,9,26]]}}}