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Innocenti A, Pizzo A. Comment to: Is Breast Magnetic Resonance Imaging Superior to Sonography in Gynecomastia Evaluation and Surgery Planning. Aesthetic Plast Surg 2024:10.1007/s00266-023-03787-0. [PMID: 38191861 DOI: 10.1007/s00266-023-03787-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 11/29/2023] [Indexed: 01/10/2024]
Affiliation(s)
- Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy.
| | - Andrea Pizzo
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy
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Innocenti A, Pizzo A. Comment to: Liposuction Assisted Gynecomastia Surgery with Minimal Periareolar Incision: a Systematic Review. Aesthetic Plast Surg 2024:10.1007/s00266-023-03786-1. [PMID: 38191863 DOI: 10.1007/s00266-023-03786-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 11/25/2023] [Indexed: 01/10/2024]
Affiliation(s)
- Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy.
| | - Andrea Pizzo
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy
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Innocenti A, Biban G. Masculinizing chest wall gender-affirming surgery: Clinical outcomes of 73 subcutaneous mastectomies using the double-incision and semicircular incision techniques. J Plast Reconstr Aesthet Surg 2023; 86:329-330. [PMID: 37500350 DOI: 10.1016/j.bjps.2023.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 07/08/2023] [Indexed: 07/29/2023]
Affiliation(s)
- Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy.
| | - Gianmarco Biban
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy
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Innocenti A, Marzouk El Araby M. Gender affirming surgery in non-binary patients: The importance of patient-centered care. J Plast Reconstr Aesthet Surg 2023; 85:498-499. [PMID: 37603984 DOI: 10.1016/j.bjps.2023.07.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 08/23/2023]
Affiliation(s)
- Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy.
| | - Mohamed Marzouk El Araby
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy.
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Innocenti A, Pizzo A. The Infero-Central Mound Reduction Mammoplasty: A Single Surgeon, 20-Year Experience. Aesthetic Plast Surg 2023:10.1007/s00266-023-03634-2. [PMID: 37697087 DOI: 10.1007/s00266-023-03634-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 08/20/2023] [Indexed: 09/13/2023]
Affiliation(s)
- Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy.
- University of Florence, Viale Giacomo Matteotti 42, 50132, Florence, Italy.
| | - Andrea Pizzo
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy
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Innocenti A, Tarantino G. Color Doppler Sonography Assisted Subcutaneous Mastectomy with Inferior Pedicled Nipple-Areola Complex in Female-to-Male Transsexuals: A Retrospective Cohort Analysis. Aesthetic Plast Surg 2023; 47:101-102. [PMID: 35882650 DOI: 10.1007/s00266-022-03035-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy.
| | - Giulio Tarantino
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Florence, Italy
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Innocenti A, Tarantino G. Endoscope-Assisted Minimally Invasive Surgery for the Treatment of Glandular Gynecomastia. Aesthetic Plast Surg 2023; 47:103-104. [PMID: 35882649 DOI: 10.1007/s00266-022-03036-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 11/01/2022]
Affiliation(s)
- Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy.
| | - Giulio Tarantino
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy
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Innocenti A, Tarantino G. Post Bariatric Male Chest Re-Shaping Using L-Shaped Excision Technique. Aesthetic Plast Surg 2023; 47:105-106. [PMID: 35882648 DOI: 10.1007/s00266-022-03038-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 11/01/2022]
Affiliation(s)
- Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy.
| | - Giulio Tarantino
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy
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Innocenti A, Melita D, Dreassi E. Incidence of Complications for Different Approaches in Gynecomastia Correction: A Systematic Review of the Literature. Aesthetic Plast Surg 2022; 46:1025-1041. [PMID: 35138423 PMCID: PMC9411245 DOI: 10.1007/s00266-022-02782-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 01/09/2022] [Indexed: 11/12/2022]
Abstract
Background Gynecomastia is nowadays a very common disease, affecting a large cohort of patients with different ages. The aim of this literature review is to assess the incidence of complications with all proposed techniques and for combined procedures versus single approach procedures in gynecomastia correction. Materials and Methods A systematic review of the literature was performed to identify all reported techniques for gynecomastia correction covering a period from January 1, 1987 to November 1, 2020. For all selected papers, demographic data, proposed technique, and complications’ incidence have been recorded. Results A total number of 3970 results was obtained from database analysis. A final total number of 94 articles was obtained for 7294 patients analyzed. Patients have been divided into three groups: aspiration techniques, consisting in 874 patients (11,98%), surgical excision techniques, consisting in 2764 patients (37,90%), and combined techniques, consisting in 3656 patients (50,12%). Complications have been recorded for all groups, for a total number of 1407, of which 130 among “Aspiration techniques” group (14,87%), 847 among “Surgical excision techniques” group (30,64%), and 430 in “Combined techniques” group (11,76%). Conclusions Several techniques have been proposed in the literature to address gynecomastia, with the potential to greatly improve self-confidence and overall appearance of affected patients. The combined use of surgical excision and aspiration techniques seems to reduce the rate of complications compared to surgical excision alone, but the lack of unique classification and the presence of several surgical techniques still represents a bias in the literature review. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Innocenti A, Melita D. Patients Decision-Making Characteristics Affects Gynecomastia Treatment Satisfaction: A Multicenter Study Using the BODY-Q Chest Module. Aesthetic Plast Surg 2021; 46:50-51. [PMID: 34845517 DOI: 10.1007/s00266-021-02688-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 11/16/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy.
| | - Dario Melita
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy
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Innocenti A, Melita D. Aesthetic Outcome of Gynecomastia Management with Conventional Liposuction and Cross-Chest Liposuction: A Prospective Comparative Study. Aesthetic Plast Surg 2021; 46:2060-2061. [PMID: 34845515 DOI: 10.1007/s00266-021-02687-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 10/19/2022]
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Percutaneous Intradermal Purse-String Closure for Correction of Male Tuberous Nipple-Areola Complex Deformity. Aesthetic Plast Surg 2021; 46:2062-2063. [PMID: 34669005 DOI: 10.1007/s00266-021-02591-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 09/11/2021] [Indexed: 10/20/2022]
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Innocenti A, Melita D, Innocenti M. Gynecomastia and Chest Masculinization: An Updated Comprehensive Reconstructive Algorithm. Aesthetic Plast Surg 2021; 45:2118-2126. [PMID: 33939025 DOI: 10.1007/s00266-021-02275-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/28/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Gynecomastia is a common finding in males. Clinical aspect varies widely in world populations showing peculiar hallmarks according to different body shapes reflecting personal expectations; therefore, a surgical plan must be tailored on individual basis to all type of patients. MATERIALS AND METHOD A total of 522 patients, treated for bilateral gynecomastia from January 2007 to January 2019, were included and reviewed in this retrospective study. Considering physical status BMI, muscular trophism, hypertrophy of the mammary region, nipple-areola disorder, gland and skin cover consistency, a four-tier classification system has been used to classify the deformity and to assess a surgical plan. In all cases, a subcutaneous mastectomy was performed under direct vision. RESULTS No recurrence of the deformity was observed as well as major complications such as necrosis, and high level of satisfaction was observed in all groups. No breast cancer was found at the histological examinations Operative time ranged from 25 minutes up to 120 minutes and hospitalization time ranged from 1 to 3 days. CONCLUSION Since the physical status is strictly related to the clinical features of the disorder, a comprehensive classification system and a reconstructive algorithm are proposed. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy.
| | - Dario Melita
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy
| | - Marco Innocenti
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy
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Expected Reduction of the Nipple-Areolar Complex over Time After Treatment of Gynecomastia with Ultrasound-Assisted Liposuction Mastectomy Compared to Subcutaneous Mastectomy Alone. Aesthetic Plast Surg 2021; 45:1350-1351. [PMID: 33258008 DOI: 10.1007/s00266-020-02052-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 10/22/2022]
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Innocenti A, Ghezzi S. Correction of High-Grade Pseudogynecomastia After Massive Weight Loss: Modified Inferior Dermoglandular Pedicled Transverse Scar Reduction. Aesthetic Plast Surg 2021; 45:367-368. [PMID: 31586217 DOI: 10.1007/s00266-019-01509-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 09/23/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, CTO Careggi University Hospital, Florence, Italy.
| | - Serena Ghezzi
- Plastic and Reconstructive Microsurgery, CTO Careggi University Hospital, Florence, Italy
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Endoscopic Axillary Approach Improves Patient Satisfaction of Gynecomastia Subcutaneous Mastectomy: A Cross-Sectional Study using the BODY-Q Chest Module. Aesthetic Plast Surg 2021; 46:166-167. [PMID: 33452542 DOI: 10.1007/s00266-020-02086-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 11/29/2020] [Indexed: 10/22/2022]
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Innocenti A, Melita D. The Vacuum-Assisted Breast Biopsy System is an Effective Strategy for the Treatment of Gynecomastia. Aesthetic Plast Surg 2021; 46:156-157. [PMID: 33403406 DOI: 10.1007/s00266-020-02053-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 11/12/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Alessandro Innocenti
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy.
| | - Dario Melita
- Plastic and Reconstructive Microsurgery, Careggi University Hospital, Viale Giacomo Matteotti 42, 50132, Florence, Italy
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Innocenti A, Ghezzi S, Melita D. Commentary on “Surgical treatment of gynaecomastia: a standard of care in plastic surgery” by Tobias R. Mett, Peter P. Pfeiler, Rosalia Luketina, Alperen S. Bingöl, Nicco Krezdorn & Peter M. Vogt. EUROPEAN JOURNAL OF PLASTIC SURGERY 2020. [DOI: 10.1007/s00238-020-01721-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Innocenti A. Male Tuberous Breast: A Rare Variant of Gynecomastia. Clinical Considerations and Personal Experience: Tips and Tricks to Maximize Surgical Outcomes. Aesthetic Plast Surg 2019; 43:1500-1505. [PMID: 31218378 DOI: 10.1007/s00266-019-01418-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 05/30/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Tuberous breast deformity, even rarely, might be observed in the gynecomastia population. It can clinically appear very similar to tuberous breast in females, including a footprint resembling a feminine inframammary fold (IMF). Because of its anatomical characteristics, its correction could benefit from particular surgical measures and therefore it should be careful diagnosed. A clear footprint defining a very feminine inframammary fold is very difficult to correct and renders very difficult the management of the extra skin. Transection of the fibrous constrictions at the level of inframammary fold is not sufficient to obtain a satisfactory result, and adjunctive surgical measurements are required. MATERIALS AND METHODS From January 2007 to December 2015, twenty-one patients, affected by gynecomastia with tuberous breast deformity, underwent surgical correction consisting of parenchyma debulking and transection of the stenotic fibrous ring of the footprint. The recontouring of the chest profile was optimized using parenchymal flaps which helped to maximize the surgical correction with minimal scarring. RESULT The mean age at surgery was 28.8 years. The average follow-up period was 32 months. The average hospitalization stay was 1.28 days. Routine laboratory tests and histological examinations did not demonstrate any anomalies. No major complications and no recurrences of the disorders have not been observed. No major complications were reported: one seroma, one skin depression, two scar revisions and three cases of bilateral minimal crescent ptotic skin appearance were observed. CONCLUSION Although tuberous breast in the gynecomastia population is a rare clinical entity, it should be taken into consideration because it could benefit from some specific surgical measures. The use of glandular flaps showed a satisfactory reshaping of the pectoral area. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Comment to: "Complications and Outcomes After Gynecomastia Surgery: Analysis of 204 Pediatric and 1583 Adult Cases from a National Multi-center Database". Aesthetic Plast Surg 2018; 42:334-335. [PMID: 29075817 DOI: 10.1007/s00266-017-0989-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 09/23/2017] [Indexed: 10/18/2022]
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