Efficacy and Safety of Liposuction and Glandular Excision for Gynecomastia: Clinical Presentation, Immediate Outcome, and Patient Satisfaction: A Cohort Study

Background: Gynecomastia can cause significant psychological distress, affecting the patient’s self-esteem and quality of life, particularly in young adults. The treatment of gynecomastia encompasses simple observation and various surgical options. The surgical modalities of gynecomastia range from liposuction alone to subcutaneous gland excision and skin reduction. The study aimed to evaluate clinical presentation, surgical intervention modality, aesthetic outcomes, and patient satisfaction following gynecomastia surgery. Methods: This retrospective, cohort, hospital-based study included patients with gynecomastia who met our inclusion criteria from June 2023 to December 2024. Patients with incomplete records, with abnormal hormonal assays, diagnosed with fatty breast, or who needed skin excision were excluded from the study. Results: Seventy-one patients who underwent breast liposuction with glandular excision were included in the study. The mean age of the participants was 24 ± 3.9 years, and the mean BMI was 26.3 ± 2.6. Most participants (n = 55, 77.5%) were diagnosed with gynecomastia grade II. The average operation time was 45.6 ± 4.7 min, with a range of 32–58 min. All procedures were completed without complications. Postoperative complications were reported in 12.7% of the participants, including superficial skin necrosis, seroma, ecchymosis, and hematoma. Most of the participants (87.3%) rated their satisfaction as very good. A significant association was noticed between high BMI and postoperative complications (p = 0.030), as well as a low level of satisfaction (p = 0.029). Conclusions: Breast liposuction and glandular excision are effective and safe surgical procedures for gynecomastia surgery. The result yields high patient satisfaction and a low complication rate. BMI is considered a crucial factor that influences surgical outcomes.