Complete Guide To Gynecomastia (Enlarged Male Breasts) In Singapore

Complete Guide To Gynecomastia (Enlarged Male Breasts) In Singapore

We all think that when it comes to breasts, they’re a concern pertaining only to the fairer gender. However, men do have breasts – even milk ducts.

With high testosterone levels produced puberty, for the vast majority of men, the breast tissue does not develop like it does for their female counterpart.

There are 2 types of conditions that affect men in Singapore.

The first is gynecomastia, which is a medical condition – men with such condition have more prominent glandular tissue present, often as a result of hormonal imbalance.  When it comes to man boobs for the majority of men, they are usually a mixture of both fat and breast tissue enlargement.

The second condition is pseudogynecomastia, which is the accumulation of excess fat tissues on the chest.

Gynecomastia: Enlarged Male Breasts

For gynecomastia, the cause of the condition is an excess of glandular male breast tissue due to hormone imbalance.

Unlike fat tissue, glandular tissue is firmer and more fibrous, and it also does not respond to diet changes nor exercise.

Gynecomastia Symptoms: Soft Lumps & Tenderness

Feel for soft lumps in your breasts. In true gynecomastia, glandular breast tissue may develop in one or both breasts.

This tissue may be located directly behind the nipple. To check for the symptom, gently feel your breast with your fingertips.‍

Should you suffer from gynecomastia, you should feel a soft, rubbery lump in one or both breasts.

Gynecomastia may occur in just one breast or both breasts at a go. And with the size of the lump varying, it may not be the same in both breasts.

Breast buds which signal the start of puberty, are typically the size of a nickel or quarter in puberty-aged boys.

Take note of tenderness. Gynecomastia may cause your breasts to be tender and sore, especially when you touch or press on them.

If your breasts are causing you a significant amount of pain or discomfort, it is advisable to make an appointment with your doctor right away.

Causes of Gynecomastia: Natural Hormone Changes, Puberty & Health Conditions

An imbalance of hormones triggers gynecomastia. A decrease in the amount of the testosterone level compared with estrogen leads to the condition.

The decline in testosterone levels can be caused by conditions that block the effects of or reduce testosterone.

It may also be a condition that increases your estrogen level. Several factors can upset the hormone balance, and these include the following:

Natural hormone changes

The hormones testosterone and estrogen not only control the development but it is a maintenance of sex characteristics in both men and women.

Testosterone takes control of male traits, such as muscle mass and body hair, while Estrogen takes control of female traits, including the growth of breasts.

Most people associate estrogen as an exclusively female hormone, but the truth is, men also produce it — though generally in small quantities.

However, when male estrogen levels are too high or are out of balance with testosterone levels, this can cause the condition, gynecomastia.

Gynecomastia during puberty

Enlarged male breasts are caused by hormone changes during puberty is relatively common.

In most cases in Singapore, the swollen breast tissue will go away without treatment within six months to two years.

As for Gynecomastia in men, the prevalence of this condition peaks again between the ages of 50 and 69 with at least 1 in 4 men in this age group being affected.

Health conditions

Several health conditions can cause gynecomastia by tilting the normal balance of hormones. These include:

  • Any of the conditions that interfere with normal testosterone production, such as Klinefelter’s syndrome or pituitary insufficiency, can be associated with gynecomastia.
  • Hormone changes that occur during the normal course of ageing can cause gynecomastia, especially in overweight men.
  • Some tumours, such as those involving the testes, adrenal glands or pituitary gland, can produce hormones that alter the male-female hormone balance.
    In this condition, the thyroid gland produces too much of the hormone thyroxine.
  • Kidney Failure. About half the people being treated with regular hemodialysis experience gynecomastia due to hormonal changes.
  • Liver Failure And Cirrhosis. Hormonal fluctuations related to liver problems as well as medications taken for cirrhosis are associated with gynecomastia.
  • Malnutrition And Starvation. When your body is deprived of adequate nutrition, testosterone levels drop, but estrogen levels remain constant. As such, this causes a hormonal imbalance. Unfortunately, Gynecomastia may persist despite resuming normal nutrition.

Common Gynecomastia Questions

Here are some common questions on gynecomastia:‍

1. Can Beer, Chicken, Eggs And Soya Beans Cause Gynecomastia?

Hoppy beers like IPA (Indian Pale Ale) contain phytoestrogen, a plant-based estrogen hormone. The common myth is that drinking too much of them will cause estrogen levels to skyrocket.

The truth is, the phytoestrogen levels are too low to create any hormone imbalance. The consumption of beers or any alcohol in excess can be detrimental to your overall health and thus, should be avoided.

Soy contains isoflavones, a class of phytoestrogens which may mildly mimic the hormone estrogen. The effects of soy isoflavones on estrogen levels are complex, but in general, soy is safe to be consumed in moderation.

As such, eggs, milk and other food products that contain hormones are safe for consumption when taken in moderation.

2. Can Steroids Eliminate Enlarged Male Breasts?

Anabolic steroids contain a lot of testosterone, which many may consider a solution since the key cause of enlarged male breasts is hormone imbalance where estrogen levels are higher.

Sounds like a solution right? Wrong.

Apart from other potential health issues, steroid use is the primary trigger for gynecomastia.

When you’re on steroids and then go off them, this results in testosterone levels fluctuating, causing an increase in your estrogen level.

This often leads to fat development in the chest area. As such, never self-medicate as this can cause your hormones to go out of whack.

Should you notice signs of gynecomastia, always seek appropriate and qualified doctor advice.

3. Does Andropause/Male Menopause Cause Gynecomastia?

Studies have shown that male menopause or andropause happens in men aged 50 or older when testosterone production drops.

Testosterone fuels changes during puberty and affects a man’s mental and physical energy as well as regulates other key evolutionary features.

As the levels of testosterone drops, it causes a hormonal imbalance and these may eventually lead to the development of enlarged male breasts.

4. Is Gynecomastia An Early Sign Of Breast Cancer?

Breast cancer is not only a concern for women since men can contract it too, albeit rarer in men. Gynecomastia, however, is not a sign of breast cancer.

Furthermore, excessive breast development and breast cancer are not found to be correlated.

When a person slims down, he will tend to see an overall reduction in size.

However, should you be suffering from true gynecomastia, your chest fullness will only look more prominent after other parts of your body have shrunk.

The only way to treat this part of your body is through a surgical intervention with gynecomastia surgery.

5. How To Get Rid Of Gynecomastia‍

Gynecomastia is a dual component problem as these excessive breasts glands and fat tissues, unfortunately, cannot be eradicated through diet and exercise alone, but with gynecomastia surgery.

6. Gynecomastia Grades On Excess Male Breasts

Enlarged male breasts tissue is divided into four different “grades”, based on the severity of the problem.

Gynecomastia Grade 1: The initial stage is characterised by minor breast enlargement without the development of excess skin. The excess skin, at this stage is found around the areola which is the coloured tissue that is surrounding the nipple.

Gynecomastia Grade 2: As the gynecomastia condition enters into the next stage, there will be a development of moderate breast enlargement without the development of excess skin. However, with enlarged male breast tissue, it now extends beyond the areola, with a minor degree of enlargement. Despite the enlargement, it is still imperceptible when a loose shirt is worn.

Gynecomastia Grade 3: Without treatment, the gynecomastia exacerbates and enters the 3rd stage. At this stage, there will be moderate breast enlargement with the development of excess skin. As the enlarged male breast tissue extends further into the breast zone, the male chest starts to look slightly like the feminine breasts and at this stage, the condition becomes clearly noticeable by others.

Gynecomastia Grade 4: As the gynecomastia enters the final stage, the condition is further aggravated with breast enlargement and excess skin. At this stage of the gynecomastia condition, patients will find that their chest appears similar to that of woman’s breasts. By now, the enlarged male breast tissue has become very noticeable and would be impossible to hide.

7. Will the skin sag after gynecomastia?

Most of the patients have degrees of gynecomastia that are not excessively saggy, as such, in these instances, the skin elasticity will ensure that the skin snaps appropriately into a more aesthetically pleasing position.

It is also important to wear the compression garment as it will help in guiding the skin back to the desired position.

8. Is recurrent gynecomastia common after gynecomastia surgery?

When a gland is removed through the procedure, it is permanently removed and does not recur. The maintenance of post-surgery is also crucial in maintaining post-surgery results, and this includes adopting a healthy lifestyle that includes diet and exercise.

How To Choose A Gynecomastia Surgery Doctor In Singapore

How To Choose A Gynecomastia Surgery Doctor In Singapore

Gynecomastia Surgery Doctor In Singapore

Gynecomastia is a real problem albeit one not openly discussed mainly among sufferers. Understandably so as it can be an embarrassing issue although it should not be an excuse for not seeking help for gynecomastia causes real pain and other possible health complications.

Gynecomastia happens due to a hormonal imbalance potentially caused by several factors. These include genetics and side effects from the use of certain medications. The condition is equally prevalent among adults and youths (teenagers included). The ideal and preferred treatment to address the condition is Gynecomastia Surgery.

Gynecomastia Surgery

It is common practice to embark on a fat and weight loss routine when excess fat becomes an issue. Most times, these practices produce results, but there are instances where they are not enough. Gynecomastia is an example.

The condition is generally associated with obese individuals, and that is perhaps the biggest misconception. Gynecomastia can be present in men with lean physiques who, on the surface, do not seem to fit into the “stereotype”. That attached stigma is probably part of the reasons why a seemingly healthy-looking individual finds it challenging to come to terms with their affliction and to seek help.

Excess male breast tissue is categorised into four different “grades.” The American Society of Plastic Surgery developed this grading system to allow gynecomastia doctors to evaluate and treat the condition accurately.

Gynecomastia Grade 1: Gynecomastia Surgery Doctor In Singapore

The initial stage is characterised by minor breast enlargement without the development of excess skin. The excess skin at this stage is found around the areola which is the coloured tissue that is surrounding the nipple.

Gynecomastia Grade 2: Gynecomastia Surgery Doctor In Singapore

As the gynecomastia condition enters into the next stage, there will be a development of moderate breast enlargement without the development of excess skin. However, with enlarged male breast tissue, it now extends beyond the areola, with a minor degree of enlargement.

Gynecomastia Grade 3: Gynecomastia Surgery Doctor In Singapore

At this stage, there will be moderate breast enlargement with the development of excess skin. As the enlarged male breast tissue extends further into the breast zone, the male chest starts to look slightly like the feminine breasts and at this stage, the condition becomes clearly noticeable by others.

Gynecomastia Grade 4: Gynecomastia Surgery Doctor In Singapore

As the gynecomastia enters the final stage, the condition is further aggravated with breast enlargement and excess skin. At this stage of the gynecomastia condition, patients will find that their chest appears similar to that of a woman’s breasts. 

Men who are suffering from gynecomastia need to know that there is help, but seeking qualified help should be the first priority.

Seeking help

Gynecomastia surgery does significantly address the condition, but it is advisable to not be too hasty in seeking help. News of botched surgeries, including of the cosmetic kind are aplenty and serves as reminders to keep a steady head notably during adversity.

When searching for gynecomastia surgery help, bear in mind a few things as you vet through the search list:

  • Ensure that the doctor is licensed to perform liposuction by the Ministry of Health, Singapore
  • Having clinical experience in particular that of male breast reduction surgery. A sense of artistic skills is also a welcomed trait in a doctor so that they can relay realistic expectations and help realise results.
  • Good communication skills are equally important, as a doctor needs to understand a patient’s concerns to help alleviate them. They should be able to address any queries and worries with confidence, based on their experience.

Dr Ivan Puah Boon Kwang, Medical Director Amaris B. Clinic, believes that body sculpting procedures, which includes gynecomastia surgery, comprises 70% Art and 30% Science. A doctor needs to be able to envision the end result with an approach that best meets the desired results. Dr. Ivan Puah is accredited by the Ministry of Health, Singapore to perform liposuction and has performed many gynecomastia surgeries.

Gynecomastia Surgery Results

Depending on the patient’s clinical condition, Gynecomastia surgery may involve removing glandular tissue and/or excess fat tissues for a flatter and more defined masculine appearance.

The advancement in technology has and continues to open up new treatment methods to address the myriad of issues of both the health and cosmetic kind. 

In the past, men who suffer from gynecomastia may have had to live with the condition for the rest of their lives but today, the path to a remedy is just a matter of a click or two away (on the internet).

Still, the onus is on the individual to do their due research and engage a qualified, and experienced doctor.


Also, Read

What is Gynecomastia

Gynecomastia Exercises


Gynecomastia Surgery In Singapore

Gynecomastia Surgery In Singapore

There are a staggering 85 percent of women and 63 percent of men being dissatisfied with the contour of at least one body part.

Aging, drug side effects, a hereditary disorder, obesity amongst many other reasons have contributed to the obnoxious condition called Gynecomastia (man breasts).

RELATED: Gynecomastia Surgery 101

The presence of enlarged man breasts has been seen to ripping confidence levels in men, and with it afflicting about 20% of men. Gynecomastia is not all that uncommon, but that does not mean you have to live with this embarrassment and insecurity.

One of the most effective ways to rid of this condition is to have a gynecomastia surgery which promises a masculine physique.

RELATED: Are You a Candidate for Gynecomastia Surgery?

With the removal of the excess fat and glandular tissue that is sitting in the chest area, the procedure restores the masculine contours of the chest and not to mention, the re-establishment of self-confidence. 

The Ministry of Health in Singapore is strict about which health professional is allowed to perform liposuction. This is why they issue licenses based on strict criteria and only a certified, recognised, and licensed doctor is allowed to perform liposuction in Singapore.


Top Singapore Men’s Insecurities. Here’s How To Fix Them!

Top Singapore Men’s Insecurities. Here’s How To Fix Them!

Nobody’s perfect. It’s normal to feel insecure about your body, or at least parts of it. Even the most confident of men experience the occasional “fat day”, or look in the mirror and think: “Who’s that uncle?”

If that’s happening to you more and more frequently, maybe it’s time to see a professional who can help you achieve your #bodygoals.Whether you’re already eating clean and working hard at the gym, yet not seeing results, or don’t see yourself giving up your long-term relationship with char kway teow and nasi lemak burgers, there are other ways to sculpt your physique.

“I have moobs!” Top Singapore Men’s Insecurities

The medical term for “man boobs” or “moobs” is gynecomastia. It’s a more common problem in Singapore than you’d expect.

The bad news: Being overweight may not be the main cause, which means that ramping up on exercise may not resolve the problem.

In fact, the swollen glands and fat deposits may be due to puberty, ageing, the side effects of certain medications or hormonal imbalance. You may even experience tenderness or pain in the area.

The good news? Gynecomastia surgery can end your pain and embarrassment. The surgery effectively reduces overly enlarged glandular tissues and/or excess fat tissues so that you can regain a more masculine physique.


Having Gynecomastia Surgery Outside Of The USA

Having Gynecomastia Surgery Outside Of The USA

The Dangers of Having Gynecomastia Surgery Outside Of The USA

Everybody likes a bargain. Whether its BOGO at the shoe store or the hot dog and a coke combination for a buck and a half at Costco, we all want to feel like we got a good deal.  This is great when it comes to clothes or shoes or lunch, but there is another saying that is equally true, “you get what you pay for”.

A number of stories have hit the national news recently about people who decided to have their plastic surgery procedures performed at a bargain basement rate outside of the US.  None of the stories ended well for the bargain hunters in these cases. And these are just the stories of people who have died as a result of surgery outside the country. A large number of other patients, mostly women, have been left scarred and disappointed after their surgeries outside the country went wrong.  Many of these patients have suffered at the hands of untrained or poorly trained “surgeons” who take advantage of unsuspecting people who want their cosmetic surgery at a discount.

So, what’s the difference between a plastic surgeon in the US and one in Mexico or the Dominican Republic?  In the US, in order to earn the moniker of Board-Certified Plastic Surgeon, you must:

  1. Excel in Medical school (top of your class) to earn a highly competitive position in a Plastic surgery residency training program that lasts 5-7 years (after medical school)
  2. Pass a rigorous comprehensive written examination and impress upon a panel of experienced, grey haired surgeons who are leaders in the field of plastic surgery in an oral examination that you are a safe, ethical plastic surgeon in order to obtain Board Certification by the American Board of Plastic Surgery.
  3. Obtain hospital privileges to practice your specialty and submit to peer review and continuing medical education in order to maintain your credentials.

Gynecomastia Surgery Outside Of The USA

Outside the US… who knows?  All you may need is a white coat, a slick website   and a sign out front of your building. The point is, you don’t know.  And that is what can be dangerous.  In the US, you can check with your local or state medical Board to check the qualifications of your surgeon. Not so elsewhere. The practitioners are banking on your desire for low ball price shopping, and you ASSUME, that they are a safe, experienced, surgeon.  It is this assumption that can prove disfiguring at best, deadly at worst.

So, what could possibly go wrong?  Everything. In a recently publicized case, a healthy woman suffered an anesthetic complication before the surgery even started. The details are sketchy as the details were not readily provided by the clinic in Mexico. And then, oops, the records are accidentally destroyed. The patient gets transferred to a local hospital and then is basically held hostage until the bill is paid in full before releasing them to be transported back to the US where she later died.  The clinic in Mexico, the doctor… ghosts. Good luck trying to track them down and leveling charges or filing suit.

That is the worst-case scenario. Say you make it back home in one piece. Can you be sure of what was injected or implanted in you? Tales of finding recycled implants or temporary sizers used as implants are what we plastic surgeons chat about when we get together at meetings. And what exactly was in that “filler” that was used?

What if you have issues after you get home? The incisions don’t look right. They are draining something awful and you can never seem to reach your surgeon in Mexico no matter when you call. You call your local plastic surgeon to get checked out, but they are not very enthusiastic about taking care of another surgeon’s complications and subjecting themselves to that liability and they politely decline.  So, you go to the ER, where you find that your insurance if you have insurance, does not cover complications of cosmetic procedures. Get ready for a medical bill that will haunt you for the rest of your life.

The moral of the story is, you get what you pay for. The BOGO shoes at DSW and the day-old bread at the bakery may be a good short-term decision with little downside.  It is definitely worthwhile to save up to hire a surgeon who has the training, experience, judgement and the skills to perform the procedure that you are considering. And yes, that does come at a price. But it is well worth it.

You wouldn’t recommend a discount, cut rate plastic surgeon to operate on your best friend or family member, would you?

Dr. Miguel Delgado Welcomes Dr. Ivan Puah From Singapore!

Dr. Miguel Delgado Welcomes Dr. Ivan Puah From Singapore!

Dr. Miguel Delgado and his staff recently welcomed Dr. Ivan Puah from Singapore to Marin Cosmetic Surgery Center, to further hone his surgical skills in gynecomastia surgery.

Dr. Miguel Delgado shared clinical and surgeries cases with Dr. Ivan Puah. Both doctors exchanged experiences on cases they have seen and performed, including post-surgery complications, surgical approaches, and more.

It was rewarding for Dr. Ivan Puah to receive one-on-one mentorship from Dr. Miguel Delgado in gynecomastia surgeries as well as observation of liposuction and a tummy tuck procedure. At the clinic, Dr. Ivan Puah had the opportunity to observe consultations, pre-operative patients, and management of post-operative patients who were having drain and suture removal.

Dr. Ivan Puah has been practicing medicine for more than 20 years with training in various disciplines including general surgery, orthopedic surgery, urology, dermatology, and many more. Since the establishment of his medical aesthetic practice, Amaris B. Clinic in 2004, Dr. Ivan Puah has been performing various types of surgical body sculpting procedures such as laserlipolysis, liposuction, VASER® Lipo, fat grafting, and gynecomastia.

Dr. Ivan Puah is a certified VASER® practitioner, obtaining his VASER® Body Sculpting training in Colorado and Argentina. In Singapore, he is accredited and recognized by the Ministry of Health to perform surgical body sculpting procedures.

“Gynecomastia is the top main concern for male patients in Singapore. As a doctor, it is important to provide patients with honest, ethical advice, as they put their trust in you; while managing their expectations realistically, working with them on achieving the results they want,” explains Dr. Ivan Puah.

We asked Dr. Ivan Puah on his key takeaway from the training, and he stated, “It was a very fruitful trip. Although I have been performing gynecomastia surgery for years, I am extremely humbled to have the opportunity to receive further training and to be mentored personally by Dr. Miguel Delgado, who is an expert in this field. He is very approachable, yet professional, and always ready to give advice. I look forward to more learning opportunities with Dr. Miguel Delgado in the near future.”, a popular educational online site, set up by Dr. Miguel Delgado and his team, is dedicated to providing comprehensive information for males who are facing issues with manboobs.

“I am glad that offers a platform for patients to share their experiences, research for the right information for their specific concerns and treatment options. To be listed on the doctor’s panel provides physicians like myself another useful channel to communicate and offer appropriate advice,” says Dr. Ivan Puah.

Visit to learn more about gynecomastia.