Pilates Instructor, 40s, improves flat nose bridge with PDO Threadlift
Ms EL, in her 40s, was concerned about her low nasal bridge affecting facial harmony and self-esteem. She sought non-surgical rhinoplasty with PDO Threads.
November 1, 2025
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.
Background
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.
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.
Our patient narratives aim to provide valuable insights into individual experiences with our clinic's treatments; however, it is imperative to acknowledge the inherent variability in results. While the information shared is genuine and reflects the real journeys of our patients, it does not purport to be representative of typical outcomes, nor does it serve as a guarantee of similar results for all individuals.
Each patient's response to treatment is contingent upon a myriad of factors, including, but not limited to, their level of commitment, lifestyle choices, and medical history. It is essential to recognise that patient narratives are illustrative examples of potential outcomes and should not be construed as predictive of specific results. We advise a consultation with our doctor for comprehensive guidance tailored to individual circumstances.
