[Patient Story] Asian Man In His 50s & His Lifelong Struggle With Gynecomastia

Amaris B.

Updated On:

Sep 19, 2023

Archive Date:

Sep 19, 2023

Mr RM, in his 50s, works in the engineering industry. His life was marked by a hidden struggle with gynecomastia. He had been silently grappling with gynecomastia for almost 40 years. 

Table of contents

Patient's Profile

Mr RM, in his 50s, works in the engineering industry. His life was marked by a hidden struggle with gynecomastia. He had been silently grappling with gynecomastia for almost 40 years. 


Mr RM's youth was marred by regular teasing, an experience that he shared had left an indelible mark on him and continued haunting him into adulthood. Reflecting on his suffering, Mr RM revealed, "The pain of gynecomastia has lingered with me for decades." On a score of 1 to 10 (1 being least affected and 10 being extremely affected) on how psychologically he was affected by enlarged male breasts, Mr R.M. rated his 8 out of 10.

Consultation & Assessment

During his consultation with Dr Ivan Puah, Mr RM shared how significant gynecomastia has affected his confidence and quality of life. He complained of bouts of discomfort and pain associated with his condition, and he is also concerned with the size of his nipples. Dr Puah conducted a thorough physical assessment, including his enlarged male breast condition, skin laxity, and muscle curvature.

Mr RM was diagnosed with a Grade III gynecomastia Type 4/5 skin; excess chest fat, and nipple facing downwards, which renders a rounded and feminine chest appearance.

Understanding Mr RM's unique concerns, Dr Puah devised a comprehensive surgical plan to address not only the Grade III gynecomastia, skin laxity, and excess chest fat but also the protruding nipples. Side effects, complications and expected results were clearly explained to the patient. Blood tests were conducted to ensure Mr RM was fit for surgery.

Treatment Plan 

In 2023, Mr RM underwent gynecomastia surgery with 360° Glandular Tissue Dissection (360°GTD®) technique by Dr Puah at an accredited Day Surgery Center under local anaesthesia. The patient was under twilight sedation, and the surgery was uneventful. Fat was removed, alongside the successful excision of glands bilaterally with skin tightening. Following that, a nipple reduction procedure was carried out.

Patients treated with gynecomastia surgery with Dr Ivan Puah's proprietary technique, the 360°GTD®, do not require suction drainage, which typically leaves ugly scars and increases the risks of infection post-op.

Post-Op Recovery & Results 

Mr RM is required to put on the compression garment for 6 to 8 weeks. Stitches were removed 10 days after the surgery. Post-op soreness was managed with pain relief medication prescribed by Dr Puah. The bruises subsided within a week, and tissue swelling gradually resolved over the following weeks.

Mr RM diligently wore his compression vest during the recovery period. His chest was flattened and sculpted with the removal of the glandular and fat tissue, and the size of his nipples was reduced.

His case underscores the transformative power of gynecomastia surgery, not only in the physical sense but in the emotional liberation it can provide.

Medical Disclaimer: Due to strict regulations from the Ministry of Health Singapore, licensed healthcare practices are not allowed to show and share before-and-after photos or videos in the public domain or through any form of push technology. "Before-and-after" or only "after" treatment visuals may be shown to patients privately during in-clinic consultation with Dr Ivan Puah.

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