{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T06:59:19Z","timestamp":1793861959962,"version":"4.6.1"},"reference-count":22,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Advanced gynecomastia\/pseudogynecomastia (Simon grades IIb\u2013III) in post-bariatric patients presents both esthetic and technical challenges. Conventional excisional methods often result in flattened chest contours, extensive scarring, and loss of nipple\u2013areolar complex (NAC) sensation. There is a growing need for conservative, tissue-preserving strategies that respect the unique morphology of massive weight-loss patients. Materials and Methods: This consecutive case series included 15 male patients (median age: 38 years, IQR 36.5\u201339.5) with advanced gynecomastia\/pseudogynecomastia and stable weight loss following bariatric surgery. All underwent a glandular transposition technique, preserving the NAC on a pedicle based on thoracic perforators and avoiding free grafting. Redundant lower-pole skin was excised, a new NAC site was created cranially, and the gland was repositioned beneath a dermo-adipose flap. Outcomes included complication rates, patient satisfaction, and changes in BODY-Q chest appearance scores. Results: No major complications occurred. NAC viability and sensation were preserved in all patients. One patient required secondary revision for residual contour bulging, while three developed minor hematomas that resolved spontaneously. At 3 months, the median Likert satisfaction score improved from 2 (IQR 2\u20133) preoperatively to 5 (IQR 4\u20135) postoperatively (p &lt; 0.001, Wilcoxon signed-rank test). BODY-Q chest appearance scores improved significantly from 31 (IQR 28\u201335) to 78 (IQR 74\u201382) (p &lt; 0.001). External observers preferred postoperative results in 90% of randomized photo-pair comparisons. Conclusions: Glandular transposition is a safe, reproducible, and esthetically effective technique for advanced gynecomastia\/pseudogynecomastia in post-bariatric men. By preserving glandular continuity and avoiding free NAC grafting, this method achieves natural chest projection, maintains nipple sensitivity, and provides high patient satisfaction with minimal complications. It represents a compelling alternative to conventional radical excision strategies.<\/jats:p>","DOI":"10.3390\/medicina61101842","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T06:06:32Z","timestamp":1760508392000},"page":"1842","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Glandular Transposition Technique for the Correction of Advanced Gynecomastia in Post-Bariatric Patients: A Case Series on a Conservative Strategy for Natural Aesthetic Outcomes"],"prefix":"10.3390","volume":"61","author":[{"given":"Feliciano","family":"Ciccarelli","sequence":"first","affiliation":[{"name":"Plastic Surgery Unit, Villa dei Fiori, 80011 Acerra, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1781-8057","authenticated-orcid":false,"given":"Felice","family":"Moccia","sequence":"additional","affiliation":[{"name":"Plastic Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Giovanna","family":"Vastarella","sequence":"additional","affiliation":[{"name":"Department of Woman, Child and General and Special Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Amoroso","sequence":"additional","affiliation":[{"name":"CARE&BEAUTY, 80035 Nola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Vastarella","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80138 Naples, Italy"},{"name":"Unit of Endocrinology and Metabolic Diseases, University Hospital, University of Campania Luigi Vanvitelli, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Vastarella","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy"},{"name":"Division of Cardiology, Cardiovascular Department, AORN Sant\u2019Anna e San Sebastiano, 81100 Caserta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gorizio","family":"Pieretti","sequence":"additional","affiliation":[{"name":"Multidisciplinary Department of Medical Surgery and Dental Sciences, University of Campania Luigi Vanvitelli, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1136\/bmj.39511.493391.BE","article-title":"Gynaecomastia and breast cancer in men","volume":"336","author":"Niewoehner","year":"2008","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","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":"Aesthet. 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