BSAPS Journal

In liposuction for gynecomastia different locations of port can beused. Among these are Central location Such as peri-areolar, intra-areolar and trans nipple areas¹. Suction of sub areolar tissue is difficult because of proximity of port. The established trans-nipple techniques that have been used to treat gynecomastia are said to have relatively less patient satisfaction rate as they leave some visible scars or mild elevation over the nipple areola complex, resulting in aesthetically unsatisfactory results. Even the slightest elevation or smallest scar over nipple areola complex leave patients extremely self-conscious and in a dilemma of having a second intervention to get rid of that blemish².Additional access incisions remote from nipple have been recommended. So, peripheral port such as sub-mammary, anterior axillary line or mid-axillary line where the scar can also become visible revealing the evidence of past surgery. The aim of study was to evaluate the outcomes of liposuction through axillary port of gynecomastia. It is a retrospective study was conducted with 30 patients enrolled in the department of Plastic and Aesthetic surgery. Period of study was from October 2020 to October 2021. Among the study population (N=15) Patients were aged from 18 to 49 years. The mean age of the samples was 26.87+- SD and the maximum and minimum age of the study population were 46 and 18 years respectively. Around 1/5th (20 %) of the study population completed Secondary school, 1/5^th (20%) completed higher secondary, three patients are studying at university, one patient completed MBBS graduation and one engineer and remaining four patients never completed secondary level. Six (40 %) were doing job at middle east & Europe as a worker, four patients were service holder and remaining five patients were students. Liposuction through an axillary incision is used to treat gynecomastia³. It avoids the large undermining between the skin and the muscular plane that frequently occurs with usual procedures. When gynecomastia is present, liposuction can be combined with an inferior periareolar incision for resection of the remaining glandular tissue. Liposuction provides a well-defined contour for the male breast. The Cannula can access all the areas of breast from the part in lower bearing area of axilla (Figure 1) The scar of this axillary port remains concealed under the cover of hair⁴. A concealed scar hides the evidence of past surgery & hence provides greater satisfaction to the patient then a visible scar.

Introduction: Gynecomastia surgery is a frequently performed procedure to address male breast enlargement, significantly improving patients’ physical and psychological well-being. Tumescent anesthesia has gained popularity due to its safety profile, reduced intraoperative bleeding, and enhanced postoperative recovery. We aim to evaluate surgical outcomes, complications, and patient satisfaction while highlighting the efficiency and safety of this technique. Materials and Method: This is a retrospective analysis reviews of 90 consecutive cases of gynecomastia surgery performed over two months using tumescent anesthesia in Bangladesh Cosmetic Surgery, Dhaka, Bangladesh. Study period was January 1 to February 28 of 2024. Result: Within these 3 months period complications like hematoma, seroma, infection, NAC necrosis and other complications and patient's safety profile and recovery were observed. Patient’s satisfaction with aesthetic outcome was excellent with no significant complication. Conclusion: Tumescent anesthesia is a reliable and safe, technique for gynecomastia surgery. With appropriate patient selection and surgical precision, it can be an effective alternative to general anesthesia for gynecomastia cases.

Introduction: The reconstruction of the soft tissue defects with exposed spine poses a challenge to reconstructive surgeons due to the curved contour and strong skin tension of the back. Implant and metal exposure increase the difficulty of covering such defects. Objective: The purpose of this study was to share our experience regarding reconstruction of soft tissue defect with exposed spine using Latissimus dorsi (LD) myocutaneous flap. Materials and Methods: This was a prospective observational study, conducted in the Burn & Plastic Surgery department of Rangpur medical college hospital, Rangpur over a period of three years July 2019 to June 2022. Here 15 patients with soft tissue defect in posterior midline with exposed spine were reconstructed with Pedicled Latissimus dorsi (LD) flap.  Outcome following the procedure in these patients was observed. Result: Among 15 patients, 12 were male and 03 were females, with male to female ratio of 4:1. The lowest age was 18 years and the highest age was 66 years with median 38 year. The major cause (80%) was post operative soft tissue defect and in 20 % case it was due to high voltage electric burn. In 8 cases there was exposed implant. The standard myocutaneous flap was harvested in all cases. The donor site was closed primarily in all cases. In 03 cases skin graft was placed over transferred muscle. The outcome of reconstruction was satisfactory in all cases. Four patients had minor complications which have managed non operatively. One of the patients had surgical site infection which was controlled according to culture-specific antibiotics, and another two patients had partial dehiscence of donor site wound which healed spontaneously. One patient developed seroma in donor site which resolved in time with local care. Conclusion: Pedicled Latissimus dorsi muscle flap is a straight forward and versatile option for reconstruction of soft tissue defect with exposed spine with minimal donor site morbidity.

Introduction: Reduction mammoplasty is a common surgical procedure for macromastia, with various techniques available to ensure optimal aesthetic and functional outcomes. Reduction mammoplasty using a superomedial pedicle and vertical scar is being practiced more and more frequently, as compared with inferior pedicle techniques using a Wise pattern skin incision. Still, there are surgeons who are practicing the IFP technique for all of their reduction mammoplasties. There is no study in our country that compares NAC complications in the two types of breast reduction. The purpose of this study is to compare the NAC complications after SMP and IFP breast reduction techniques. Objective: This study aims to compare NAC complications following the use of the superomedial pedicle and inferior pedicle techniques in 100 consecutive cases. Methods: A retrospective analysis was conducted on 100 patients (200 breasts) who underwent reduction mammoplasty over a period of 12 years, with 58 cases performed using the superomedial pedicle technique and 42 using the inferior pedicle technique. Postoperative NAC complications, including partial or total necrosis, and sensory impairment, were assessed over a minimum follow-up period of six months. Results: SMP generally demonstrates lower rates of NAC venous congestion and partial necrosis compared to IP, especially in large-volume reductions, due to its shorter pedicle length and robust vascular supply from internal mammary perforators. IP, however, offers reliable perfusion for moderate reductions but shows higher rates of sensory loss and NAC bottoming out over time. In our study, partial NAC loss occurred in 11.90% of the inferior pedicle cases versus 1.72% in the superomedial pedicle cases. Total NAC loss was observed in 2.38% of inferior pedicle cases and 0% of superomedial pedicle cases. Sensory loss was also more frequent in the inferior pedicle group (21%) than in the superomedial pedicle group (5%). Conclusion: The superomedial pedicle technique appears to be associated with a lower rate of NAC complications compared to the inferior pedicle technique. Given the reduced risk of NAC necrosis and sensory impairment in the superomedial pedicle approach, this technique appears to be a preferable option for reduction mammoplasty surgeries.

Introduction: Post acne scars impact an individual's self-esteem and appearance. Various therapeutic methods can be used to lessen the scar, such as, laser, dermabrasion, surgical excision. Microneedling is one of the recent technologies in this aspect that focuses on breaking down damaged collagen of dermis and promotes neo-collagen formation. Methods: 65 patients with mild to moderate post acne atrophic scar were included in this study. All patients received 5 sequential treatments of microneedling with an interval of 4 weeks. A blinded dermatologist assessed patient outcome according to qualitative global acne scarring system grading of Goodman & Baron. Patients were questioned about their satisfaction and any adverse reaction at an interval. Result: 48 patients under study were women, and 17 were men. Their ages varied from 15-35 years old. Of them 27% had a positive family history of acne scarring. The average length of the illness was 6.80 ±1.16 years, while the average time for scarring was 4.75 ±1.18 years. With varies type of complications, common are post-inflammatory hyperpigmentation and post procedure pain; but most of the case had no complains. Most of the patient’s response were very good (73%) than excellent (20%). Conclusion: Microneedling is reviewed as a well satisfactory mode of treatment in post acne scars.

Eyebrows are key to facial aesthetics and expression, framing the eyes and contributing to facial harmony. Their importance extends beyond cosmetics, as they anchor muscles involved in facial movement. Eyebrow loss caused by trauma, burn or medical conditions can lead to emotional distress. Hair transplantation, particularly Follicular Unit Extraction (FUE), offers a minimally invasive, effective solution with natural-looking results. This technique involves transplanting individual hair follicles, usually from the scalp, to restore brow shape, density, and symmetry. This article shares our experience with FUE eyebrow restoration in 21 patients, covering technique, management, and outcomes. Materials and Methods: this study was conducted at cosmetic surgery centre limited. Period was study was from January 2018 to January 2022. Total number of cases done was 21. Result: Overall results were satisfactory and there were no significant complications. Conclusion: Excellent result can be obtained eyebrow hair transplant, if patient selection and technical details are properly performed.