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More Middle-Aged and Older Men Are Seeking Male Breast Reduction In Singapore, says Dr Ivan Puah

The mean age of men seeking gynecomastia surgery at Amaris B. Clinic Singapore was 33. However, recent years have witnessed a notable increase in older male patients above 42, with the oldest being 70.

SINGAPORE, MARCH 2024 – Dr Ivan Puah, a Singapore MOH-accredited liposuction doctor with years of experience in gynecomastia and corrective surgeries, has observed a growing number of middle-aged and older male patients seeking treatment for enlarged male breasts at Amaris B. Clinic. This surge underscores the emotional, physical and psychological[1] impact of gynecomastia, particularly among mature men who prioritise mental health, well-being and self-care. 

Gynecomastia is a medical condition characterised by the abnormal enlargement of fibrous glandular and fatty breast tissues in men, which can occur on one or both sides.  

Traditionally, the average age of men seeking gynecomastia surgery at Amaris B. Clinic was 33. However, recent years have witnessed a notable increase in older male patients above 42, with the oldest being 70. 

Gynecomastia is more common in middle-aged and older males than expected

The various contributing factors that lead to the development of gynecomastia in mature men include hormonal imbalances, such as those associated with andropause, obesity, the use of prescription medications, underlying medical problems and also anabolic steroid usage.  

Psychological stress is one of the causes of the intermittent occurrence of gynecomastia, as higher levels of cortisol and estradiol are noted, along with a reduction in testosterone levels during periods of stress [2].

46% of Singaporeans put mental health as the #1 health issue facing the country today, according to survey

The Ipsos World Mental Health Day 2023 report revealed alarming statistics regarding Mental Health and stress levels in Singapore, with a significant portion of respondents reporting feelings of stress, depression and anxiety. Notably, these mental health challenges often exacerbate the emotional stress experienced by individuals coping with gynecomastia.  

Dr Ivan Puah emphasises the crippling effects of gynecomastia on self-esteem and mental health. Middle-aged and older gynecomastia sufferers whom Dr Ivan Puah has treated share that they had anxiety, felt depressed and experienced discrimination because of their condition. As a result, they tend to walk with their heads down and layering clothes in an attempt to hide their breasts. Many of them struggle with low confidence and body image issues despite having succeeded professionally. 

“Gynecomastia is a medical condition that causes male breast swelling, pain and also distress for affected individuals. It greatly affects one’s self-esteem and mental well-being. Many patients I’ve treated have grappled with extremely low self-esteem. Older men are now taking proactive steps to address this condition, probably due to wanting to take charge of their lives and not letting a medical condition dent their self-image to continue living their best life,” shares Dr Puah.



  1. Song, B., Bi, K., & Sun, P. (2022, December 20). Examining the prevalence and correlates of probable depression and anxiety among Chinese males diagnosed with gynecomastia.
  2. Gooren LJ, Daantje CR. Psychological stress as a cause of intermittent gynecomastia. Horm Metab Res. 1986 Jun;18(6):424. doi: 10.1055/s-2007-1012336. PMID: 3732992.