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Psychological Effects of Gynecomastia

Gynecomastia, also known as man boobs or enlarged male breasts, is a medical condition that affects over 60% of males. The effects of gynecomastia go beyond physical discomfort and feminine appearance.
Gynecomastia Glands Amaris B. Clinic Singapore

Glands of enlarged male breasts from a male patient, excised by Dr Ivan Puah, who has been performing gynecomastia surgery for over a decade.

  • Depression & anxiety
    Men with gynecomastia who do not seek surgical intervention have the psychological burden of depression and anxiety [1].
    Body image perception is disturbed in adolescents with gynecomastia [2].
    Gynecomastia as a condition causing a feminized outlook may have a negative impact on self esteem and body image [3]
    The child may appear more withdrawn, has erratic mood swings and prefers to be alone, opting out of social activities.

Gynecomastia VS Pseudogynecomastia

Gynecomastia and pseudogynecomastia may look the same physically, but they are very two different conditions.


Involves only the glandular tissue or glandular tissue with a combination of excess fat tissues on the chest.

✕ Pseudogynecomastia
Due to only fat deposits without the involvement of glandular tissues.


Hormonal imbalance leading to the development of enlarged breast tissues. It can affect one or both breasts.

✕ Pseudogynecomastia
It is simply due to the extra fat accumulation in the chest area, usually caused by weight and/or fat gain.

Tell the difference

The affected area can feel sore, tender, and/or painful, accompanied with swelling and sometimes, nipple discharge. You will feel a firm, rubbery lump in one or both breasts.

✕ Pseudogynecomastia
Breasts feel soft and evenly enlarged. There is no pain or soreness upon touch. Your areolas are not enlarged, and your nipples are not sore or discharging.

Recommended treatments

Gynecomastia surgery involving 360° Glandular Tissue Dissection (360°GTD®) and liposuction.

✕ Pseudogynecomastia
Modern Liposuction with the MDC-Sculpt®️ Lipo technique can effectively address pseudogynecomastia by removing excess chest fat.

Gynecomastia SCALE

Adapted from the McKinney and Simon, Hoffman and Kohn scales [4]

Grade I

Small breast enlargement with a localised button of tissue concentrated around the areola.

Grade II

Moderate breast enlargement exceeds areola boundaries, with edges indistinct from the chest.

Grade III

Moderate breast enlargement exceeds areola boundaries with edges distinct from the chest with skin redundancy present.

Grade IV

Marked breast enlargement with skin redundancy and feminisation of the breast.

Gynecomastia SYMPTOMS & Self-Check

When the person wears a form-fitting T-shirt, the breasts look like female breasts.
Other gynecomastia symptoms may also include swelling, pain, soreness and, in some extreme cases, nipple discharge.

Suspect that you may be suffering from gynecomastia? Do a self-check!

Pinch Test

When you pinch a typical breast tissue, it usually feels firm. The tissue may also resist the pinch a little. Also, when you pinch the areola from end to end with your thumb and forefinger, the tissue rim should be no bigger than 1/2 cm in diameter. When one has gynecomastia, there would be no resistance and no tissue rim.

Visual Inspection

Normal male chest has a thin layer of tissue with small flat areolas. You are certainly suffering from gynecomastia if your chest looks more feminine, and has puffy nipples with abnormally wide areolas.

Touch Assessment

If you can feel a firm mound of mass around the areola area that feels painful or tender to touch, you are likely suffering from gynecomastia.

Dr Ivan Puah at Amaris B. Clinic
Dr Ivan Puah during a fat grafting and liposuction surgery in Singapore | Amaris B. Clinic Dr Ivan Puah
Dr Ivan Puah at Amaris B. Clinic


Dr Ivan Puah has over 17 years of liposuction and body contouring experience. He is certified to perform Laserlipolysis (Laser Liposuction), *VASER liposuction, having completed his fundamental and advanced body sculpting training in Italy, the U.S. and Argentina.

His passion for body contouring further drives Dr Ivan Puah to receive dedicated training in gynecomastia in the U.S. He developed two proprietary surgical techniques: 360° GTD® for gynecomastia surgery and MDC-Sculpt®️ Lipo Technique for liposuction.

He is known to patients as a pragmatic gentleman- managing realistic expectations, not overpromising and under-delivering results.

*VASER (Acronym for Vibration Amplification of Sound Energy at Resonance)


At what age is gynecomastia permanent?

This misunderstanding frequently occurs because teenage boys can develop gynecomastia throughout puberty, which goes away in two years or less. In cases where gynecomastia persists for over a year, it will likely become permanent. In adults, the development of gynecomastia is often associated with increasing age, body fat, and an increase in estrogen/androgen ratio.

Once developed, gynecomastia that persists after 6 months of unsuccessful medical treatment will require surgery.

Does gynecomastia surgery last forever?

Usually, your gynecomastia condition will not return after surgery, as most of the enlarged breast tissue and fat in that area is excised. Depending on your pre-existing clinical condition, the doctor may leave a small amount of breast tissue behind to avoid crater deformity in the future. Should you notice any changes in your results in years to come, that is probably due to weight gain or skin laxity.

Will I be awake during gyno surgery?

With Dr Ivan Puah's surgical approach, there is no need for the patient to undergo general anaesthesia. The patient will be under twilight sedation during the procedure. Our anesthesiologist will ensure that you are safe and comfortable throughout the process.

What if gynecomastia is left untreated?

Aside from discomfort and pain, gynecomastia, if left untreated, will not improve or resolve by itself. It may affect the individual physically, emotionally, mentally and psychologically.

Will chest workouts get rid of moobs?

No, chest workouts will not eliminate moobs or enlarged male breasts. This is because glandular tissues do not respond to this method. Gynecomastia surgery is still the best option to eradicate the condition effectively.

Male with long nipples - Normal or a medical issue?

Men complaining of long nipples are a minority and are bothered mainly by their appearance. Nipple reduction surgery is a solution to treat this condition.

How much does a gynecomastia surgery cost in Singapore?

The costs of gynecomastia surgery in Singapore will vary between practices, and the following factors will determine the price.

Generally, the doctor's fees for performing gynecomastia surgery are based on experience and the case's complexity. Other charges include the type of anaesthesia used, surgical facility costs, medical tests such as blood tests, post-surgery garments, pre and post-medication, specimen (biopsy), etc.

While costs are one of the variables you need to consider, the doctor's experience and the variety of gynecomastia cases he has treated and your comfort level with him are just as necessary as the final cost of the surgery.

Can I get rid of gynecomastia with cream, pills or non-invasive treatment such as fat freezing?

No. Gynecomastia is a male breast disorder involving abnormal proliferation of breast tissues. It cannot be treated non-surgically with fat freezing or low-energy laser, nor can it be resolved by exercising or dieting. Cream and spray will not work either.

Is gynecomastia surgery covered by insurance or MediSave?

Before understanding if your gynecomastia surgery is covered financially by insurance or MediSave, we encourage you to visit Dr Ivan Puah for a consultation.

A complete history, physical examination, and appropriate diagnostic tests are needed to determine the underlying cause of your condition. Following that, he will be able to advise you on whether surgery is medically necessary or not. If proven it is, you may be able to tap into your insurance or MediSave.

Is your question not listed here?
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Contact us

Opening Hours 
Weekdays: 9:30am - 7pm
Alternate Saturdays: 9am - 5pm
Closed on Sundays & Public Holidays

I'm interested in TELECONSULTATION

Thank you!
Your submission has been received.
We will reply you as soon as we can!

OOPS! Something went wrong while submitting the form. Please call us at 6536 4211 instead.

Contact us

Opening Hours 
Weekdays: 9:30am - 7pm
Saturdays: 9:30am - 1:30pm
Closed on Sundays & Public Holidays

I'm interested in TELECONSULTATION

Thank you!
Your submission has been received.
We will reply you as soon as we can!

OOPS! Something went wrong while submitting the form. Please call us at 6536 4211 instead.

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MOH approved operating theatre | Amaris B. Clinic Dr Ivan Puah

MOH-approved Operating Theatre & Post-recovery Center

Our yearly-audited MOH-approved OT is equipped with modern surgical equipment and European monitoring systems with private suites and 12-bed recovery units. It has direct hospital access and blood transfusion facilities.

Group of | Amaris B. Clinic Dr Ivan Puah

Our Esteemed & Experienced Panel Of Anaesthesiologists

Performing surgeries at an accredited facility with our panel of anaesthesiologists and offering comfortable twilight sedation (no GA) allows the best possible care, safety and monitoring for you during surgery.

Our personalised care | Amaris B. Clinic Dr Ivan Puah

Personalised Care

No one body is the same. You are unique, and so are your concerns, needs and desires. This is why every treatment plan varies for each different patient. We listen to what you want before designing your personalised plan to meet your goals.

Dedicated Patient Care, Quality Assurance & Delivering Results

Integrity, ethical, and commitment, that's our pledge to you. Dr Ivan Puah is known to patients as a pragmatic gentleman - managing realistic expectations, not overpromising and under delivering results.

Our Result Difference

BOok your consultation
Having the surgery done is just the beginning to your new body confidence, it is not the end of it. We are with you every step of the way. That is why we have tailored a comprehensive post-treatment care program designed to fully optimise your results.

Proprietary 360° Glandular Tissue Dissection (360°GTD®️) and MDC-Sculpt® lipo techniques allow:

• Thorough glandular tissue removal
• Precise chest sculpting
• Minimal scarring and incidence of haematoma
• Lesser downtime, bruising and pain
• Faster recovery with minimal disruption to your daily activities

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[1] Nuzzi, Laura C. B.A.; Cerrato, Felecia E. M.P.H.; Erikson, Cameron R. B.S.; Webb, Michelle L. B.A.; Rosen, Heather M.D., M.P.H.; Walsh, Erika M. M.D.; DiVasta, Amy D. M.D., M.M.Sc.; Greene, Arin K. M.D., M.M.Sc.; Labow, Brian I. M.D.. Psychosocial Impact of Adolescent Gynecomastia: A Prospective Case-Control Study. Plastic and Reconstructive Surgery 131(4):p 890-896, April 2013. | DOI: 10.1097/PRS.0b013e3182818ea8
[2] Esenboğa, S., Akgül, S., Kanbur, N., Tüzün, Z., & Derman, O. (2015). The effect of gynecomastia on body image perception and gender roles in adolescents. Turk J Pediatr, 57(1), 60-67.
[3] El Noamani, S., Thabet, A. M., Enab, A. A., Shaeer, O., & El-Sadat, A. (2010). High grade gynecomastia: surgical correction and potential impact on erectile function. The Journal of Sexual Medicine, 7(6), 2273-2279.
[4] Simon, B.E., Hoffman, S., Kahn, S. Classification and surgical correction of gynecomastia. Plast.
Reconstr. Surg. 51:48-52, 1973.