Gynecomastia & Pseudogynecomastia Differences

Amaris B.

Archive Date:

November 20, 2020

Dr. Ivan Puah, Medical Director of Amaris B. Clinic, who has treated a number of gynecomastia patients, observed that the majority of men who came in with complaints of pseudogynecomastia were shown to have mixed gynecomastia after medical assessment.

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Blog last updated on:

January 4, 2023

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 that can affect up to 65 percent of young and adult men globally.


Gynecomastia, an enlarged male breast medical condition in men, is caused by hormonal imbalance. Some of the 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 4 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 in appearance to a female breast.


Genetically, men tend to accumulate fat in the chest and abdomen area – as they age or become overweight. When fat builds up behind and around the breast area, the chest may appear puffy and  full. 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 this may lead to further enlargement of breast tissues or gynecomastia.

Dr. Ivan Puah, Medical Director of Amaris B. Clinic, who has treated a number of gynecomastia patients, observed that the majority of men who came in with complaints of pseudogynecomastia were shown to have mixed gynecomastia after medical assessment.

Gynecomastia Surgery

Gynecomastia, unfortunately, cannot be eradicated through diet and exercise alone. Amaris B. Clinic offers 4-Dimensional (4D) Gynecomastia Surgery, not only to comprehensively remove the excess glandular and fat tissues but also to further reshape, sculpt and tighten the chest and improve the nipple size.

Having undergone dedicated training in gynecomastia surgery in the USA, Dr Ivan Puah further refined his surgical skills and developed a novel surgical technique - 360° Glandular Tissue Dissection (360°GTD®). Endoscopic-line incision not bigger than 4mm is created to allow extraction of the fat and breast tissues, thus allowing for better recovery, lesser downtime and minimal scarring.

VASER Lipo is then performed to further shape or sculpt the chest to achieve a more toned and defining chest contour.

Pseudogynecomastia Treatment

In most patients, male breasts fat tissue can be rather resistant to weight loss, so losing weight may not lead to significant improvement.  Conversely, weight gain will likely lead to fat accumulation in the breasts.

VASER Lipo 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.

Dr Ivan Puah utilises the VASER probe that transmits ultrasonic sound wave energy to the targeted fat tissues to emulsify the stubborn fat. He then carefully suctions the liquefied fat with a specialised cannula and further contours the chest, leaving the area with a sculpted look. Once the fat cells are liquefied, they are removed via suction cannulas that are specially made for this procedure.  

As VASER Lipo is a tissue-selective fat reduction procedure, it only targets fat tissues, preserving the health of nerves, blood vessels and other important connective tissues. Therefore, post-treatment recovery is easy and with minimal downtime because only the fat tissues are targeted and removed.

Bruising and swelling are minimized with this procedure.  As VASER Lipo is a form of liposuction (albeit an improved form of liposuction), it can only be performed by doctors who are trained and accredited by the Ministry of Health (MOH) Singapore.

As a proven clinical treatment for pseudogynecomastia, many men have benefited from its results. While this is certainly good news for those afflicted with the condition, bear in mind to practise due diligence in one's research when seeking help.

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 in particular that of male breast reduction surgery. A sense of artistic skills is also a welcomed trait in a doctor so that he can relay realistic expectations and help realise results.

  • Excellent 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 great aesthetic sense. Dr Ivan Puah believes that body sculpting procedures, which includes gynecomastia surgery, comprises 70 percent art and 30 percent science. A competent and skilled doctor needs to be able to envision the end result with an approach that best meets the desired results.

  • Ensure the gynecomastia surgery doctor is accredited by the Ministry of Health, Singapore to perform liposuction and has performed many gynecomastia surgeries. Dr. Ivan Puah has received various liposuction and body sculpting training overseas. He is a certified VASER physician with vast experience in performing VASERLipo, VASER Hi-Def and body contouring correction surgeries since 2008. He is the only doctor in Asia to receive dedicated surgical training in gynecomastia surgery in the USA.

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 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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