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Gynecomastia & Pseudogynecomastia Differences

November 20, 2020
February 9, 2024

Dr Puah observed that the majority of men who came in with complaints of pseudogynecomastia were shown to have mixed gynecomastia after medical assessment.

Table of Contents

Gynecomastia is a real medical problem that not many have openly discussed mainly among sufferers.

In a 2019 study by the American Society of Plastic Surgeons, male breast reduction or gynecomastia surgery is on the rise among men - having increased by 30 percent over the past five years, more than any other plastic surgery procedure for men.

Gynecomastia may cause discomfort, pain and severe distress emotionally and physically. This medical condition is the most common male breast deformity; affecting up to 65 percent of young and adult men globally.


Gynecomastia or an enlarged male breast, is a medical condition in men and is commonly caused by hormonal imbalance. Some common causes of hormonal imbalance are physiological changes during teenage years, obesity, steroid abuse, liver disorders, certain cancers and others. Physiological stimulus, obesity and steroid abuse are the top 3 commonest causes of gynecomastia. Gynecomastia is more common than most people thought. It affects 1 out of 2 teen boys and 2 out of 3 men above 50 years old.

There are four grades in gynecomastia classification, with the mildest being just a local swelling around the nipple area and the most severe showing a pronounced rounded appearance with excess skin folds, similar to a female breast.

Read more:

How Gynecomastia Affects Men’s Chest Shape

How Gynecomastia Look Like In Men Of Different Ages


Genetically, men tend to accumulate fat in the chest and abdomen area – as they age or become overweight. The chest may appear puffy and full when fat builds up behind and around the breast area. Unlike gynecomastia, the breast tissues remain small or normal in size. This is clinically known as adipomastia, or pseudogynecomastia.

Interestingly, fat also causes your body to produce the aromatase enzyme, which can convert excess testosterone into estrogen and may further enlarge breast tissues.

Dr Ivan Puah, Medical Director of Amaris B. Clinic, who has treated many gynecomastia patients, observed that most men who came in with complaints of pseudogynecomastia actually suffer from mixed gynecomastia.

Gynecomastia Surgery

Gynecomastia, unfortunately, cannot be eradicated through diet and exercise alone. Amaris B. Clinic offers 4-Dimensional (4D) Gynecomastia Surgery. The objective is to remove excess glandular and fat tissues, further sculpt the chest contour, improve skin laxity and nipple size.

Each gynecomastia case is unique. The surgical approach developed by Dr Ivan Puah considers the degree of the gynecomastia, glandular tissue-to-fat ratio and parenchyma distribution of the patient. He will propose an individualised approach for the patient after carefully assessing the patient's clinical condition and understanding the patient's concerns.

Dr Ivan Puah's ultimate aim is to remove fibrous and painful glandular tissues and/or fat tissues to restore a natural-looking masculine body shape with the smallest possible incision for his patients. Thus, he has developed two proprietary surgical techniques, 360°GTD® and MDC-Sculpt®️ Lipo Technique.

During the surgery, eendoscopic-line incisions not bigger than 4mm is made strategically on the target area to allow infiltration of anaesthetic fluid.

Through the small incision, a 360° glandular tissue dissection is performed carefully following the physiological disposition of the glandular tissues. Not only can the affected tissues be removed effectively, but scarring is also minimal, and the risks of haematoma are significantly reduced. Next, to remove excess fat chest (for mixed gynecomastia), he will perform modern liposuction with his MDC-Sculpt®️ Lipo Technique. He carefully removes stubborn fat with a specialised cannula, further contouring and sculpting the area for a more defined chest contour.

Pseudogynecomastia Treatment

Fat deposits that reside at the male chest are quite stubborn! Generally, the first line of action that you can take to tackle pseudogynecomastia is through dietary changes and lifestyle adjustments such as exercise. It may help to a certain extent, but when it doesn’t, modern liposuction with MDC® Lipo Sculpt Technique is the recommended treatment for this.

Modern Liposuction with MDC® Lipo Sculpt Technique is a body contouring procedure that removes stubborn fat tissues in the problematic area, firms the skin and creates a more contoured and defined chest.

Vaser Liposuction is the treatment choice for those suffering from pseudogynecomastia. During the process, small incisions are made on the area to treat, shape and tighten the chest.

Gynecomastia Surgery Doctor in Singapore

Dr Ivan Puah of Amaris B. Clinic during gynecomastia surgery in Singapore  | Dr Ivan Puah, Gynecomastia Surgery Doctor in Singapore, Amaris B. Clinic

When searching for gynecomastia doctor in Singapore, there are a few things to bear as you run through the search list:

  • Having a wealth of surgical experience, particularly that of male breast reduction surgery.
  • Good communication skills are equally important, as a doctor needs to understand a patient's concerns to help alleviate them. He should be able to address any queries and worries with confidence based on his experience.
  • Ensure the doctor has a great aesthetic sense. Dr Ivan Puah believes that body sculpting procedures, which include gynecomastia surgery, comprise 70 percent art and 30 percent science.
  • A competent and skilled doctor needs to be able to envision the result with a surgical approach that can deliver the desired results.
  • Ensure the gynecomastia doctor is accredited by the Ministry of Health, Singapore to perform liposuction.

Dr Ivan Puah has received various types of liposuction training overseas, including Vaser Liposuction, Laserlipolysis (Laser Liposuction), 4D Liposuction (Hi-Definition Liposuction), and tumescent liposuction.

He is certified to perform Vaser Liposuction, and has amassed vast experience, in body contouring procedures and corrective liposuction. On top of that, he is the only doctor in Singapore to receive dedicated surgical training in gynecomastia surgery in the USA.

In the past, men who suffered from gynecomastia may have had to live with the condition forever. Today, the path to a remedy is just a matter of a click or two away (on the internet).


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