GelPOINT single-incision access with yellow enhancement imaging for endoscopic gynecomastia surgery.

INTRODUCTION: Standard endoscopic gynecomastia surgery, while offering better cosmetic outcomes than open procedures, is often hindered by suboptimal visualization of the glandular-adipose interface, instrument clashing due to multiple concealed ports, and the risk of nipple-areolar complex (NAC) ischemia. This paper describes a technical modification using a single-incision platform and advanced imaging to overcome these limitations. METHODS: The authors utilize the GelPOINT Mini platform for single-site access through a concealed 3-cm incision behind the anterior axillary fold. To enhance visualization, the VISERA ELITE III Yellow Enhancement (YE) imaging system is employed. This technology brightens fat-rich yellow tissues, allowing for a clearer distinction between the glandular tissue and overlying fat. This technique is specifically indicated for Simon Grade IIa-IIb patients with firm glandular tissue and minimal skin excess. RESULTS: The single-incision approach eliminates instrument clashing and poor triangulation associated with multi-port techniques. The use of YE imaging facilitates a more precise dissection in the plane beneath the NAC, reducing the risk of vascular compromise, residual pathology, and contour irregularities. CONCLUSION: The integration of a single-port platform with Yellow Enhancement imaging offers a refined approach to endoscopic gynecomastia surgery. By improving visualization and ergonomics, this modification enhances surgical precision and aesthetic outcomes while minimizing visible scarring.