Objective: To investigate the clinical effect of liposuction combined with subareolar incision glandectomy in the treatment of Simon Grade Ⅲ adipo-glandular gynecomastia (GYN). Methods: From March 2021 to March 2022,...Objective: To investigate the clinical effect of liposuction combined with subareolar incision glandectomy in the treatment of Simon Grade Ⅲ adipo-glandular gynecomastia (GYN). Methods: From March 2021 to March 2022, the data of patients with Simon Grade Ⅲ adipo-glandular GYN treated by liposuction combined with glandectomy in the Department of Plastic Surgery, Zhongshan Hospital Affiliated to Dalian University and Henan Plastic Surgery and Aesthetic Hospital were retrospectively analyzed. Based on the medical records, color ultrasound was performed on the patient’s breast before surgery, which was determined to be GYN (more than 50% glandular tissue). A 3 mm long incision was made at the lower boundary of the surgical range, through which the adipose tissue in the hypertrophic region of the breast was repeatedly aspirated until a satisfactory thickness was achieved. The residual glandular tissue was removed by a semicircular arc incision under the areola, and then the areola incision was sutured in position. The blood flow, sensation, and wound healing of bilateral nipples and areola were observed after surgery, and the morphology of bilateral thorax and scar of incision were followed up. Results: A total of 15 GYN patients aged 18 to 35 years with body mass index of 23.8 to 26.5 kg/m2 (mean = 24.8 kg/m2) were included in this study. The average intraoperative liposuction volume of unilateral breast was 170 mL (150-200 mL), the average glandectomy volume was 115 g (95-125 g), and the average blood loss was about 40 mL (15-75 mL). Postoperative hypertrophic breast volume decreased significantly, and no complications such as hematoma, infection, skin ischemic necrosis, or sensory disturbance occurred in the nipple and areola, during the healing process. The patients were followed up for 3 to 6 months, and the bilateral thorax was smooth, symmetrical, and natural in contour. The incision was concealed, and the scar was not obvious. Conclusion: Liposuction combined with subareolar incision glandectomy in the treatment of Simon Grade Ⅲ adipo-glandular GYN is safe. The postoperative chest contour is smooth and natural, and the scar is small and invisible, which achieves good aesthetics.展开更多
Girls'age of onset puberty has decreased globally in recent years.Emerging evidence suggests that exposure to phthalate esters(PAEs)could play a role in this trend.However,the relationship between PAE exposure and...Girls'age of onset puberty has decreased globally in recent years.Emerging evidence suggests that exposure to phthalate esters(PAEs)could play a role in this trend.However,the relationship between PAE exposure and pubertal development in Chinese girls remains poorly understood.The present study aimed to address this issue by investigating the link between levels of urinary phthalate ester metabolites(mPAEs)and the risk of early puberty among 546 Chinese girls(6-8 years old)over a two-year monitoring program.Poisson regression,restricted cubic spline models,weighted quantile sum regression,and Bayesian kernel machine regression were used to assess both individual and combined effects of PAEs on pubertal development.Significant links were found between urinary concentrations of monoisobutyl phthalate(MiBP),monobutyl phthalate(MnBP),mono-(2-ethyl-5-oxohexyl)phthalate,the total of low molecular weight mPAEs,the total of nine commonly detected mPAEs,and the total of all mPAEs with the risk of early breast development(all P-trend<0.05).Furthermore,levels of MnBP,MiBP,low molecular weight mPAEs,and mono-(2-ethyl-5-oxohexyl)phthalate were positively associated with early menarche.Mixture effect analysis revealed incidence rate ratios of 1.64(95%confidence interval(CI):1.10-2.45)for early breast development and 2.33(95%CI:1.22-4.45)for early menarche.Short-chain mPAEs,particularly MiBP and MnBP,were identified as the major contributors to this combined effect.The present study demonstrated that exposure to PAEs,particularly short-chain PAEs,could lead to the early onset of puberty in Chinese girls.展开更多
文摘Objective: To investigate the clinical effect of liposuction combined with subareolar incision glandectomy in the treatment of Simon Grade Ⅲ adipo-glandular gynecomastia (GYN). Methods: From March 2021 to March 2022, the data of patients with Simon Grade Ⅲ adipo-glandular GYN treated by liposuction combined with glandectomy in the Department of Plastic Surgery, Zhongshan Hospital Affiliated to Dalian University and Henan Plastic Surgery and Aesthetic Hospital were retrospectively analyzed. Based on the medical records, color ultrasound was performed on the patient’s breast before surgery, which was determined to be GYN (more than 50% glandular tissue). A 3 mm long incision was made at the lower boundary of the surgical range, through which the adipose tissue in the hypertrophic region of the breast was repeatedly aspirated until a satisfactory thickness was achieved. The residual glandular tissue was removed by a semicircular arc incision under the areola, and then the areola incision was sutured in position. The blood flow, sensation, and wound healing of bilateral nipples and areola were observed after surgery, and the morphology of bilateral thorax and scar of incision were followed up. Results: A total of 15 GYN patients aged 18 to 35 years with body mass index of 23.8 to 26.5 kg/m2 (mean = 24.8 kg/m2) were included in this study. The average intraoperative liposuction volume of unilateral breast was 170 mL (150-200 mL), the average glandectomy volume was 115 g (95-125 g), and the average blood loss was about 40 mL (15-75 mL). Postoperative hypertrophic breast volume decreased significantly, and no complications such as hematoma, infection, skin ischemic necrosis, or sensory disturbance occurred in the nipple and areola, during the healing process. The patients were followed up for 3 to 6 months, and the bilateral thorax was smooth, symmetrical, and natural in contour. The incision was concealed, and the scar was not obvious. Conclusion: Liposuction combined with subareolar incision glandectomy in the treatment of Simon Grade Ⅲ adipo-glandular GYN is safe. The postoperative chest contour is smooth and natural, and the scar is small and invisible, which achieves good aesthetics.
基金support from the National Natural Science Foundation of China(No.81673201)the Guangdong Basic and Applied Basic Research Foundation(Nos.2022A-1515011605 and 2024A1515012044)+1 种基金the Shenzhen Science and Technology Program(Nos.JCYJ20180307095536403,JCYJ20220530162412029,and JCYJ20230807141908018)and South China University of Technology(No.x2hj−D6242050).
文摘Girls'age of onset puberty has decreased globally in recent years.Emerging evidence suggests that exposure to phthalate esters(PAEs)could play a role in this trend.However,the relationship between PAE exposure and pubertal development in Chinese girls remains poorly understood.The present study aimed to address this issue by investigating the link between levels of urinary phthalate ester metabolites(mPAEs)and the risk of early puberty among 546 Chinese girls(6-8 years old)over a two-year monitoring program.Poisson regression,restricted cubic spline models,weighted quantile sum regression,and Bayesian kernel machine regression were used to assess both individual and combined effects of PAEs on pubertal development.Significant links were found between urinary concentrations of monoisobutyl phthalate(MiBP),monobutyl phthalate(MnBP),mono-(2-ethyl-5-oxohexyl)phthalate,the total of low molecular weight mPAEs,the total of nine commonly detected mPAEs,and the total of all mPAEs with the risk of early breast development(all P-trend<0.05).Furthermore,levels of MnBP,MiBP,low molecular weight mPAEs,and mono-(2-ethyl-5-oxohexyl)phthalate were positively associated with early menarche.Mixture effect analysis revealed incidence rate ratios of 1.64(95%confidence interval(CI):1.10-2.45)for early breast development and 2.33(95%CI:1.22-4.45)for early menarche.Short-chain mPAEs,particularly MiBP and MnBP,were identified as the major contributors to this combined effect.The present study demonstrated that exposure to PAEs,particularly short-chain PAEs,could lead to the early onset of puberty in Chinese girls.
