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Cryolipolysis For Pseudogynecomastia

Jan 16, 2018


A new study suggests that invasive procedures are not necessarily the only options for treating pseudogynecomastia.

Traditionally, pseudogynecomastia — male breast enlargement due to excess subareolar fat — is treated with either liposuction or surgical excision, or a combination of the two. According to 2014 statistics from the American Society for Aesthetic Plastic Surgery, treatment of pseudogynecomastia or gynecomastia is the third or fourth most common cosmetic procedure performed on men.

The new study touts cryolipolysis as a viable, effective treatment that has the benefit of being non-invasive. The study enrolled 21 men with pseudogynecomastia. They received an initial treatment consisting of a 60-minute cryolipolysis cycle, followed by a two-minute massage and a second 60-minute cycle with 50% treatment area overlap. At 60-day follow-up, patients received a second 60-minute treatment. Safety was evaluated by monitoring side effects and adverse events. Efficacy was assessed by ultrasound, clinical photographs and patient surveys.

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Surveys reported 95% of patients had improved visual appearance, while 89% experienced a reduction in embarrassment associated with pseudogynecomastia. Ultrasound showed a mean fat-layer reduction of 1.6 ± 1.2 mm. Blinded reviewers correctly identified 82% of baseline photographs. Reported side effects included mild discomfort during treatment and transient paresthesia and tenderness. One case of paradoxical hyperplasia (PH) occurred.

“Cryolipolysis, as used in this off-label indication during the study, is safe and effective for treating enlarged male breasts,” study co-author Girish S. Munavalli, M.D., assistant professor of dermatology at Wake Forest University School of Medicine, tells Cosmetic Surgery Times. “This is a non-invasive procedure which can be performed within a matter of hours, and results are seen as quickly as six to eight weeks. This study conclusively showed, with standardized photography and ultrasound measurements, that reduction in breast size is measurable and significant. Just as important, quality of life improves as a result of this treatment. This has profound effects on self-esteem and specifically allows men to feel better in certain types of clothing and in social settings such as the gym, pool and outdoors or exercise activities.”

Disclosures

The study, which appears in the September issue of Dermatologic Surgery, was supported by a research grant from Zeltiq Aesthetics, manufacturer of the CoolSculpting System. Dr. Munavalli has been a consultant for Zeltiq.