[Patient Story] Mid-40s Caucasian Man, Botched Gynecomastia Surgery

Patient's Profile

Mr D is a mid-40s Caucasian living in Thailand for many years. He flew to Singapore to consult and seek surgery with Dr Ivan Puah a few years ago.

Background 

Mr D's complex surgical history includes two previous attempts to address gynecomastia; both surgeries left him unsatisfied. 

The first surgery, conducted more than ten years ago, focused on liposuction of the chest and abdomen. After this surgery, Mr D felt that there was no significant improvement to his chest. 

In 2018, he had repeated gynecomastia surgery. According to the patient, the doctor attempted gland removal using liposuction during this procedure but with no success. It resulted in unevenness, lumps around the nipples and loose skin. 

Mr D was extremely upset over the outcome and wanted to consult Dr Puah for a second opinion. 

Consultation & Assessment

During the consultation, Mr D expressed frustration with his prior surgical experiences. He highlighted his disappointment, stating that the glands were not removed in either of the previous procedures despite his specific concerns and requests. 

Upon clinical examination by Dr Puah, Mr D presented with several concerning issues, including: 

• Palpable breast glands indicating gynecomastia 
• Adhesions resulting from prior surgeries 
• Noticeable unevenness, indentations and depressions in the chest area
• Loose skin around the chest

Treatment Plan 

After a meticulous assessment and having understood Mr D's concerns, Dr Puah proposed a comprehensive corrective surgery plan including:

• Glandular excision with his 360°GTD® technique. This aims to thoroughly remove the enlarged breast glands, a key aspect overlooked in Mr D's previous surgeries
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• Autologous fat grafting to rectify the unevenness, indentations and depressions present in the chest area
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• Non-surgical skin tightening treatment to improve skin laxity

Dr Puah also spoke to the patient regarding the complexity of his condition, and Mr D will need to be realistic about the results. 

Mr D's immediate concern is the glandular tissues and unevenness; he is less concerned about the loose skin, and he decides to opt for the gynecomastia corrective surgery with fat grafting to the chest. He will consider the skin tightening treatment at a later stage. 

The corrective surgery was carried out smoothly without complications. Fat was grafted from the periumbilical region and injected into multiple areas around the chest. Bilateral enlarged glandular tissues were removed successfully.  

Post-Op Recovery & Results 

Mr D had his wound reviewed before returning to Thailand and had the stitches removed. He later returned to Singapore a few months later for a review. He was satisfied with the surgical outcome; the chest was flattened, and the indentations were even out.