Response to "Comment to 'Comparison of Non-liposuction and Liposuction Techniques in Single-port Endoscopic Subcutaneous Mastectomy for Gynecomastia: A Retrospective Analysis'".

We appreciate the insightful comments by Dr Innocenti regarding our recent comparison of non-liposuction and liposuction techniques in single-port endoscopic subcutaneous mastectomy (ESCM) for gynecomastia. In this reply, we address concerns regarding scar visibility, skin redundancy management, tumescent fluid volume, postoperative compression, and the role of ultrasound-assisted liposuction (UAL). Our findings demonstrate that the axillary incision offers superior concealment in Asian patients with sparse chest hair, while also serving as a standardised access route for future endoscopic breast oncological surgery. The non-liposuction technique significantly reduces operative time and early drainage without compromising safety or satisfaction. We agree that technique selection should be individualised, but emphasise the anatomical and educational advantages of the axillary approach in our population.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors  www.springer.com/00266 .