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Gynecomastia And How It Impacts Your Confidence for National Service (NS) 

June 14, 2022
February 3, 2024

Here is a breakdown of the different grades, how gyno affects your self-esteem, and what can be done to get you ready for your NS journey in full confidence.

Table of Contents

Was the first thing you did when you received your Full-time National Service (NS) enlistment letter to look down at your chest? You have a few months to go before officially serving the nation, and as proud and eager as you are to be the backbone of Singapore's defence, you are anxious and worried about your enlarged male breasts.

On the Official MINDEF website, there is a dedicated page on how to prepare for NS. One of the pieces of advice provided is to "train up your fitness so you can hone mental resilience to deal with training better."

Getting physically fit for NS prepares you to adapt to the rigour of basic training as a recruit. It is much easier if you are physically fit and prepared for your Pre-Enlistee Individual Physical Proficiency Test (IPPT).

If you are investing time and effort in training to get fit, kudos to you! We wish you the best in your NS journey.

However, if you are working out daily in the hope of losing those enlarged male breasts you are embarrassed and worried about, we are sorry to share that this medical condition does not go away with exercise or diet because they are enlarged male tissues and not only fat. Unless, of course, what you have is actually pseudogynecomastia.

Do you know that gynecomastia can look even more prominent as you lose weight? If this business of gynecomastia and pseudogynecomastia makes you confused and even more anxious, we got your back, Jack!

Here is a detailed breakdown of these two types of man boobs conditions, the different grades, how gynecomastia affects your self-esteem, and what can be done to get you ready for your NS journey in full confidence.

Enlarged Male Breasts: Gynecomastia and pseudogynecomastia

Gynecomastia is a common breast lesion that accounts for more than 65 percent of male breast disorders. Hormonal imbalances such as increased estrogen activity, decreased testosterone activity, or the use of certain types of medications to treat specific medical conditions are some of the common causes of gynecomastia.

In certain instances (brace yourselves for this bad news, gym junkies), it can be a side effect of taking anabolic steroids. Gynecomastia is usually bilateral (affects both sides of the breasts), but it can also be unilateral (affects only one side), causing an obvious asymmetrical appearance.

Gynecomastia can be further classified into:

  • True gynecomastia, where only glandular tissue is the cause
  • Mixed gynecomastia, where both overdeveloped glands and excess fat are involved.

Pseudogynecomastia, on the other hand, refers to a condition whereby fat accumulates on the chest. For this condition, exercise can have a significant impact, especially when accompanied by a healthy diet. Liposuction is recommended to remove the unwanted chest fat permanently when diet and exercise fail to produce any significant result.

Suspect you may have gynecomastia? 

There are self-evaluation methods that can be done to determine what you are facing. You might be suffering from gynecomastia if you can feel a tender, firm, and mobile disc-like mound of tissue when pressure is applied to your breasts.

Another obvious sign is when the affected area resembles a female's breasts. Other symptoms of gynecomastia may also include swelling, pain or soreness. ‍

Remember that you can only be 100 percent sure of your diagnosis by going for a proper and thorough physical examination by a doctor experienced in treating gynecomastia cases.

Gynecomastia In Teenagers and Adult Males

According to the National Institutes of Health, 50 to 60 percent of adolescent males suffer from gynecomastia. The symptoms of gynecomastia in younger people are usually caused by higher-than-normal estrogen levels in the body due to puberty. Although it is not unusual for the condition to regress over time, this is not always the case.

Nearly 65 percent of men between 27 and 92 years old had some kind of gynecomastia. The reasons for gynecomastia in adolescents and adults are highly diverse, even though the symptoms are comparable. Adult gynecomastia is usually associated with increasing age due to progressive testicular hypofunction and, increased weight and body fat.

What is the grading scale of your gynecomastia? 

A classification from Simon, Hoffman and Kahn was adopted, known as the "Gynecomastia Scale." This scale enables gynecomastia doctors to standardise the discussion of issues and treatment of gynecomastia. Gynecomastia (True and Mixed) is universally classified into Grade I, II, III, and IV according to the severity of the breast tissue enlargement.

How does gynecomastia affect your body confidence during NS? 

Soldiers packed for training

The size of an enlarged male breast can go up to a C- or D-cup size. An oversized nipple-areola complex (puffy nipples) can appear distorted and look feminine. When the gynecomastia sufferer wears a form-fitting shirt, the breasts look like female breasts with some droopiness and loose skin.

If you have man boobs, take a few moments to answer these questions sincerely and note your emotions as you think about your answers:

  • How does removing your shirt in front of others make you feel?
  • Does the thought of your NS mates staring at your chest make you cringe, anxious and even angry?
  • Do you feel that there is a possibility of being made fun of by your bunk mates for having a female-like chest?

Body dissatisfaction has resulted in a high percentage of males with extremely low self-confidence, anti-social behaviour and poor mental health and wellbeing. As men are more clammed up about their feelings and insecurities, they tend to take matters into their own hands.

The pills or lotions that promise to reduce the size of your gynecomastia you found online are nothing but a gimmick. Nothing you do, eat, or apply can revert the enlargement of your breast glands; neither can fat freezing or low-energy laser, except for surgical intervention in the form of gynecomastia surgery.

Dr Ivan Puah, who has over 15 years of gynecomastia surgery experience, cited instances where male patients teared up as they shared the reasons behind their low self-esteem. "In Singapore, the number of young adults who suffer from gynecomastia is high. They usually will opt to have the affected glandular and fat tissues removed to relieve their symptoms before they report for enlistment. They have a sense of helplessness, and they want to know that you understand and can help them." Studies have further substantiated his observation that men do not share their body insecurities with their peers or family.

How to get rid of Gynecomastia safely and permanently? 

Enlarged male breast glands removed during gynecomastia surgery by Dr Ivan Puah, Medical Director of Amaris B. Clinic
"Men who suffer from gynecomastia often feel ashamed of their body, but I always assure them that this medical condition is more common than they thought. There is no shame in seeking professional help to relieve the symptoms and improve the physical appearance of the chest. In my practice, every process is important — from consultation, assessment, and planning of the surgical approach to surgery and post-op care. Gynecomastia surgery can be life-changing and impactful to the patient when it is done right. Therefore, it is crucial to consider the condition of each unique individual. No one gynecomastia case is the same, so it should not be done in a cookie-cut manner," explains Dr Ivan Puah.

He concludes that gynecomastia surgery, like any other body contouring surgery, is 30 percent science and 70 percent art. It is a challenging procedure as it requires the doctor to apply the appropriate surgical technique, considering the degree of breasts droopiness, gland size, fat, and skin laxity to achieve an aesthetically pleasing result for his patient.

Dr Ivan Puah's dedicated gynecomastia surgical training in the United States and his years of experience treating various types of gynecomastia cases have led him to refine his skills and develop his proprietary surgical approach, the 360° Glandular Tissue Dissection (360°GTD®). Not only can he remove the affected glandular tissues effectively, but scarring is minimal, and the risks of hematoma are also minimised. The chest is flattened and sculpted to reveal a more defined chest contour.

Post-surgery, the patient must don a compression vest to reduce post-tissue swelling and assist in skin retraction for about 4 to 6 weeks. Other than some restrictions with heavy lifting or gym work such as upper body chest works and water activities for a few weeks, the patient can return to daily activities without much hassle in a day or two post-op.

"When I developed 360°GTD®, it was with the objective of reducing the possible risks such as hematoma, the use of suction drains post-op that traditional gynecomastia surgical approach has, which may increase the risk of infection and scarring. This approach allows my patient to recover fast, and appreciate the improved chest contour sooner," shares Dr Ivan Puah.

Choosing the right doctor to help you with your gynecomastia issue

Gynecomastia doctor in Singapore, Dr Ivan Puah, during an enlarged male breasts surgery

Wanting to proceed with the surgery is an important decision. Choosing an experienced doctor with years of experience in surgical body contouring and checking out reviews is just one of the many important factors to consider.

Clear Communication

During the consultation, the doctor should give you a clear and uncomplicated explanation and show you a variety of gynecomastia cases that he has performed. This will give you an idea of what to expect from your results.

Be sure to discuss with the doctor your needs and goals. Choose an empathetic doctor with good bedside manners, who is confident and whom you are comfortable with.

Quality, Experience & Trust Over Cost Of Gynecomastia Surgery In Singapore

Costs for gynecomastia surgery will vary between practices, and the following factors will determine the cost. In general, the doctor's fees for performing gynecomastia surgery are based on their experience and the complexity of the case.

Other charges include the type of anaesthesia used, hospital or surgical facility costs, medical tests such as blood tests, post-surgery garments, pre and post-medication, specimen (biopsy), etc.

While costs are one of the variables you need to consider, the doctor's experience and the variety of gynecomastia cases he has treated and your comfort level with him are just as important as the final cost of the surgery.

Ensure that the doctor you choose performs the procedure in an accredited surgical facility with a team of well-trained surgical medical and support staff.

Any questions on gynecomastia? Check out Dr. Ivan Puah, Amaris B Clinic Singapore

To know if your gynecomastia surgery is claimable by insurance or MediSave, you must first ascertain that your enlarged male breast is a medical condition and it is medically necessary to remove it.

We encourage you to consult with Dr Ivan Puah, who will be able to identify the root cause of your condition. During your consultation, please share with him your complete medical history. Physical examination and appropriate diagnostic tests will also be done for a thorough assessment.

Body sculpting is Amaris B. Clinic's forte. He believes that no matter how advanced technology and science are, the result of a body sculpting procedure still predominantly depends on a doctor's skills and eye for aesthetics.

Dr Ivan Puah and his medical team value honesty, and the results and well-being of their patients are their primary focus.

Let them take care of your enlarged male breast issues while you just focus on doing your best during NS. Your renewed body confidence is just an appointment away.


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