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Between 2018 and 2023, Dr Ivan Puah treated over 550 cases, addressing unique challenges in Singapore's multi-ethnic population.
Between 2018 and 2023, Dr Ivan Puah treated over 550 cases, addressing unique challenges in Singapore's multi-ethnic population. His study included diverse case profiles. Results revealing no complications and high satisfaction prove the need to adapt surgical techniques for variations in skin type between Asian and Caucasian patients.
SINGAPORE, June 2026 – The evaluation and management of surgical treatment for gynecomastia primarily focus on Western populations. However, Amaris B. Clinic's decades of experience in Singapore highlight specific considerations for Asian patients.
Dr Ivan Puah, Medical Director at Amaris B. Clinic and the lead researcher on a recent study, has offered new insights into treating gynecomastia, a condition characterised by male breast enlargement, in Singapore.
The research paper titled ‘Surgical Management of Gynecomastia in Asian Men - Clinical Experience and Considerations for Different Patient Types’ provides detailed, important considerations, including the management of the consultation process, addressing varying patient expectations, and tackling the surgical aspects necessary to achieve desired aesthetic outcomes.
Between 2018 and 2023, Dr Puah treated over 550 cases at Amaris B. Clinic and presented six representative patient cases that illustrate the demographics and unique challenges faced by this multi-ethnic Asian population.
The typical patient profiles included obese, overweight, and lean adults, as well as adolescents. Common causes of gynecomastia observed in the patients included hormonal changes during puberty, drug-induced gynecomastia from anabolic steroids, and conditions related to weight loss.
Dr Puah's proprietary surgical methods involve making a single incision along the areola to minimise scar visibility while effectively excising glandular tissue, performing liposuction to remove excess fat, and tightening the chest skin.
| Gynecomastia Grade | Demographic | Profile |
|---|---|---|
| Grade II | 17-year-old Chinese | A history of bilateral breast enlargement since 13 years-old. |
| Grade II | 18-year-old Chinese | A history of bilateral breast enlargement since 12 years-old. |
| Grade II | 22-year-old Malay | Using anabolic hormone supplements for bodybuilding for 4 years. |
| Grade II | 46-year-old Chinese | Took anabolic steroids for 5 years. |
| Grade IV | 28-year-old Chinese | Overweight since childhood. No reduction in breast enlargement despite losing weight. Skin laxity present. |
| Grade IV | 21-year-old Indian | Overweight since childhood. No reduction in breast enlargement despite losing weight. Skin laxity present. |
At the 3-month follow-up after surgery, 5 of 6 patients reported no complications, highlighting the effectiveness of the tailored surgical approach. They expressed high satisfaction with the aesthetic results of the procedure, rating it a perfect 7 out of 7, and reported relief from emotional distress.
Only one patient experienced mild keloid formation at the edges of both areolae where incisions were made, which were not easily noticeable, and reported no complications or dissatisfaction.
Dr Ivan Puah emphasises, “It is important to adapt surgical techniques to address issues such as scarring and hyperpigmentation, which can be more pronounced in Asian patients due to their skin types. The differences in skin quality and glandular tissue characteristics between Asian and Caucasian patients with gynecomastia necessitate distinctions in treatment planning, particularly regarding careful incision placement.”
The full paper is available via World Journal of Plastic Surgery at https://pmc.ncbi.nlm.nih.gov/articles/PMC12843043/
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ABOUT AMARIS B. CLINIC
Amaris B. Clinic, established in 2004 in Singapore and led by Dr Ivan Puah, focusing on medical aesthetics and cosmetic surgery.
The clinic offers facial and body sculpting services such as liposuction, gynecomastia surgery, and fat grafting, as well as non-surgical treatments like Ultherapy Prime, biostimulator injections, and hair loss therapy.
Amaris B. Clinic’s Signature Treatments
ABOUT DR IVAN PUAH
Dr Puah, an MOH-accredited liposuction doctor with extensive training in various cosmetic procedures, is committed to providing personalised care with an artful eye and proven medical techniques.
