The Dome technique: A single-stage liposuction and dermopexy treatment for high-grade gynecomastia

Background: Gynecomastia is a benign, excessive development of the male breast that occurs at an overall incidence of 32% to 36%. The goals of surgical treatment are to restore the breast contour with minimal scarring and protect the areolar anatomy and sensation. Here, a new single stage technique is described where peripheral fat tissue is effectively removed using ultrasound-assisted liposuction (UAL) followed by a Dome breast lifting from the superior parabolic periareolar incision without touching the complex inferior pedicle. Methods: A retrospective review of outcomes for 29 patients aged between 18 and 49 years with grade IIB or grade III gynecomastia who were treated with UAL and the Dome technique. Health-related quality-of-life and aesthetic outcomes were evaluated using a modified version of the Breast Evaluation Questionnaire (BEQ). Results: The mean Likert-type score (LS) increased from 1.82 (18%) preoperatively to 4.10 (81%) months postoperatively ( p < 0.05). No infection, nipple–areola complex necrosis, nipple retraction, or saucer deformity was encountered. Conclusion: The use of UAL and Dome technique for the treatment of severe gynecomastia allows for the effective removal of both the fat and glandular tissue of the breast through a minimal periareolar parabolic incision. This technique can achieve excellent aesthetic results with inconspicuous scarring in a single session.