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[Press Release] Dr Ivan Puah, Medical Director Of Amaris B. Clinic, Discovers The Main Period Men Between 35 And 50 Year-olds First Experience Gynecomastia in Singapore

While the most popular age group of men going for gynecomastia surgery is from 35 to 50 years old, the main period they first experience this medical condition is very early in life. Dr Ivan Puah has designed a Unique 360° Glandular Tissue Dissection Technique to better improve results of gynecomastia surgery.

SINGAPORE, August 2020 — Dr Ivan Puah, Medical Director of Amaris B. Clinic, is accredited by the Ministry of Health to perform surgical body sculpting procedures such as liposuction. Amaris B. Clinic is one of the few medical clinics in Singapore to offer gynecomastia and is an approved medical facility for body contouring procedures. Dr Ivan Puah is an experienced and reputable physician in the field of body sculpting and aesthetic medicine. He has more than a decade of experience in treating gynecomastia for men from all walks of life and age groups.

Hormonal imbalance, genetics and in some, the use of anabolic steroids, may lead to the development of gynecomastia. Gynecomastia may occur as a side effect from prolonged use of certain medications due to other medical conditions. Other factors, such as weight loss and ageing, may also contribute to enlarged male breasts development. However, the most common cause of gynecomastia is actually idiopathic.

From Dr Ivan Puah’s wealth of experience in gynecomastia consultation, assessment and surgery in Singapore, he has discovered that the main period in their lives most of his patients first noticed and experienced enlarged male breasts is during adolescence.

Dr Ivan Puah explained, “Because gynecomastia happens when there is hormonal imbalance, the surge usually happens during puberty, from 14 to 20 years old. If the enlarged male breasts do not subside within a year after its development, the medical condition will become permanent. Besides pain, increased skin sensitivity, discharge and others, gynecomastia often also causes overwhelming psychological symptoms such as anxiety, depression, low self-esteem, anti-social behaviours in affected individuals. In young adults, it often adversely affects their psycho-social development, studies, work and interpersonal relationships.”

Gynecomastia Classifications 

The most used classification is based on tissue components involved in gynecomastia are:

  1. True Gynecomastia: When glandular tissue is the primary cause of male breast enlargement.
  2. Pseudogynecomastia: When it is due to only fat deposits without the involvement of glandular tissues.
  3. Mixed Gynecomastia: When both fat and glandular tissues are the cause of enlarged male breasts enlargement 

“Some patients with gynecomastia are not even aware they suffer from this medical condition. The prevalence of asymptomatic gynecomastia is 50 percent to 60 percent in adolescents and up to 70 percent in men aged 50 to 69 years. Men between 35 to 50-year-old either suffered from gynecomastia since young and finally decided to seek treatment or have recently developed the symptoms due to ageing or weight gain,” said Dr. Ivan Puah.

Gynecomastia surgery is recommended for those suffering from gynecomastia for longer than 12 months, and those whose condition does not resolve independently or with other means of management. The surgery is suitable for patients who have prominent bilateral breasts enlargement or unilateral (one-sided) breasts asymmetry. It is also suitable for patients with saggy breasts following weight loss and dieting and those with protruding and prominent areolas.

Dr Ivan Puah’s Unique 360° Glandular Tissue Dissection Technique

Over the years, many gynecomastia doctors around the world adopted different types of surgical techniques which play a significant role in the end result for the patient. Having undergone dedicated training in gynecomastia surgery in the USA, Dr Ivan Puah further refined his surgical skills and developed a 360° Glandular Tissue Dissection (360°GTD®) technique.

Endoscopic-line incision, not bigger than 4mm, is first created to allow infiltration of anaesthetic fluid on the area to be treated. By creating endoscopic-like incisions, Dr Ivan Puah effectively reduces the invasiveness of the procedure, allowing a more desired cosmetic outcome. Through this incision, a 360°GTD® is then performed carefully following the physiological disposition of the glandular tissues.

VASER Lipo is performed on those with fatty tissues enlargement of the breasts. The VASER probe delivers ultrasonic sound wave energy which breaks down the fat cells efficiently while leaving the surrounding connective tissues, blood vessels and nerves relatively undisrupted. Dr Ivan Puah then carefully suctions the liquefied fat with a specialised VASER cannula and further contours the chest, leaving the area with a sculpted look. Furthermore, VASER Lipo stimulates collagen production for better skin tightening.

“Based on my experience, each gynecomastia case is unique, and the surgical approach should not conform to one-type-fits-all. During the assessment, I’ll carefully consider the degree of the gynecomastia, and glandular tissue-to-fat ratio and thereafter propose an individualised approach for the patient. Ultimately, my aim is to reduce breast size by removing fibrous and painful tissue and/or fat tissue to restore a natural-looking masculine body shape, with the smallest possible incision,” says Dr Ivan Puah.