Liposuction is the most effective treatment for armpit fat, typically costing from SGD $4,000 onwards in Singapore, depending on the doctor’s experience, etc.
March 15, 2026
Table of Contents
Gynecomastia results from enlarged breast tissue (glands and fat) rather than only fat.
The male breast tissue is overdeveloped and becomes enlarged, causing soreness, pain and discomfort for the affected individual. It is a medical condition that can also indicate underlying health problems.
Exercising or losing weight will not reduce or remove enlarged male breasts. The only effective treatment for gynecomastia is surgical correction [1].
Main causes of enlarged male breasts: Testosterone deficiency & Hormonal Imbalance
Gynecomastia is a common male breast disorder that stems from an imbalance between the hormones androgen and estrogen.
Enlarged male breasts affect males of all ages, including newborns, during puberty, and older adults. In fact, according to a study [2]:
- Gynecomastia in infancy is common, and it usually goes away on its own before the baby reaches 1 year old
- Hormonal imbalances are prevalent during puberty, but a high percentage of adolescent gynecomastia tends to resolve on its own within a year or two
- The incidence of enlarged male breasts in adults increases with age
Usually once gynecomastia occurs in adults, it does not regress.
Underlying health conditions that cause gynecomastia
Systemic Disorders
Systemic disorders are health conditions that affect the entire body when a single organ or more in the respiratory, neurological, circulatory, or digestive systems is affected.
Hyperprolactinemia
Medications can cause hyperprolactinemia, a condition of elevated prolactin levels in the blood [14].
Prolactin is a hormone responsible for lactation, breast development, and other functions.
While prolactin is not directly responsible for causing gynecomastia, it suppresses the hormone-releasing hormone that helps your sex glands mature and function.
Prolactin receptors are also present in male breast tissue and may lead to gynecomastia [15].
Renal disease
Chronic renal failure is commonly associated with hyperprolactinemia.
Renal disease can lead to testosterone deficiency, which may result in enlarged male breast tissue [16].
Kennedy syndrome
1 in 40,000 men suffer from Kennedy's disease.
It is a genetic motor neuron disease that can cause muscular weakness, muscle atrophy and muscle twitch, usually occurring after testosterone resistance between the ages of 40 and 50 [17].
Androgen insensitivity syndrome
Androgen insensitivity syndrome is when a person is born male but is resistant to male hormones.
In this rare syndrome, gynecomastia develops during puberty and does not regress spontaneously [18].
Graves' Disease: Hyperthyroidism and hypothyroidism
Graves' disease is an autoimmune thyroid disorder, the most common cause of hyperthyroidism.
Hyperthyroidism occurs when the thyroid gland produces too much thyroid hormone.
Enlarged male breasts have been reported in about 40% of men with hyperthyroidism. [19].
Testicular Germ cell tumours
Germ cell tumours are growths of cells from reproductive cells in the testicles or the ovaries.
It stimulates testosterone production and increases the conversion from androgens into estrogens.
Some germ cell tumours occur in other parts of the body, such as the abdomen, brain, and chest [20].
Liver disease
Gynecomastia is commonly found in patients with liver cirrhosis, which is the severe scarring of the liver [21, 22].
This liver disease and the side effects of its medication disrupt the hormonal levels, thus encouraging enlarged male breasts.
Male Menopause (Andropause)
Andropause, also known as male menopause, can cause low sex drive, erectile dysfunction, low energy, depression and mood swings. This is due to declining testosterone levels associated with ageing.
Men undergoing andropause with gynecomastia are primarily physiological.
In the United States, it is estimated that there are about 2.4 million men aged 40 to 69 years old who have lower levels of testosterone [13].
Prescribed medications that cause gynecomastia
Various medications have been associated with gynecomastia as they contain "estrogenic properties, metabolise testosterone, and enhance estrogen production" [2].
Medications for high cholesterol (statins), bacterial infections (amoxicillin) and gastrointestinal diseases (proton pump inhibitors) are at higher risk of developing enlarged male breasts [24].
Case reports in 2018 on "Statin Medications And The Risk Of Gynecomastia" by Skeldon et al. suggested an increased risk of gynecomastia with statins, a class of drugs often prescribed to help reduce cholesterol levels [25].
Causes of Testosterone deficiency
According to Mieritz et al., causes of testosterone deficiency [23] include:
Lifestyle choices that create hormonal imbalance
Natural Herbs And Oils – A Natural Disaster Waiting To Happen. What about soy?
With the increasing awareness of the importance of health, natural products are commonplace on supermarkets' food shelves, including the grooming section.
When applied topically in large amounts, products such as herbal supplements [4] and, lavender and tea tree oils [5] may lead to gynecomastia.
These are commonly found in shampoos, lotions and soaps, and while the notion may seem far-fetched to the uninformed individual, it can happen.
Soy proteins, despite containing high levels of phytoestrogens (estrogen-like compounds derived from plants), no scientific proof has been that soy causes enlarged male breasts [6].
Obesity
Obesity, as we know it, is the cause of many health problems, gynecomastia included.
Obesity lowers testosterone levels, thus causing havoc to your muscle-to-fat and estrogen-to-androgen ratio [7].
The male hormone androgen will convert into estrogen in the subcutaneous fat.
Excessive fat in obese men may worsen the appearance of man boobs.
Alcohol abuse and cigarette smoking
Gynecomastia is more common in men who have drunk alcohol and smoked cigarettes before (67% and 43%) [8].
This habit has been known to cause many diseases.
Smoking cigarettes has also been known to decrease testosterone production, which will eventually cause hormone imbalance.
A study published in the American Journal of Epidemiology found that smokers who smoke more than 36.5 packs a year "show a faster age-related decline in testosterone than non-smokers" [9].
Alcohol abuse affects the liver's ability to get rid of excess estrogen, and when it can't function effectively, it may also start converting androgens into estrogens.
Smoking also causes hormone imbalance and, like excessive drinking, will eventually result in enlarged male breasts as it lowers your testosterone [10].
Abuse of anabolic steroids
The common uses of anabolic steroids are for bulking up and performance enhancement. It has been reported that 1% to 5% of men abuse steroids in their lifetime [11].
While side effects such as roid rage seem to take centre stage most of the time, other equally pressing side effects such as gynecomastia should not be ignored.
Anabolic steroid contains aromatase, an enzyme that converts androgens into estrogens [12].
Note that this can also occur with legal steroids, so always remember that there are no shortcuts to success!
Cannabis Abuse
The direct relationship between cannabis abuse and gynecomastia has been successfully proven.
Cannabis abuse encourages hyperprolactinemia and low serum testosterone levels [13].
In Singapore, cannabis use, in any form, is illegal.
Gynecomastia surgery
Gynecomastia surgery has been the only effective solution to permanently remove the enlarged male breast tissue for decades. Suitable candidates include those whose condition does not resolve independently within a year.
Gynecomastia surgery is also known as a chest masculinisation surgery as it aims to remodel the contour of the chest - whether you have enlarged male breasts in one or both chests - and relieve pain and discomfort associated with the medical condition.
If your condition causes protruding or prominent areolas, the surgery can rectify the issue.
We welcome you to call us and schedule a consultation with Dr Ivan Puah to understand how we can help you address your issue.
