Malay man in 40s beat steroid-induced gynecomastia

Patient's Profile

Mr F, a 40-year-old communications professional, found himself grappling with a frustrating medical condition known as gynecomastia after discontinuing anabolic steroid use.

Background 

For years, Mr F participated in combat sports and uses  anabolic steroids to enhance his performance. After several years of use, he began to notice concerning changes in his body — specifically, a significant enlargement of his breasts.

Initially, he dismissed these changes, thinking they would resolve quickly. Mr F soon experienced discomfort and tenderness in his chest, which persisted and affected both sides. Despite diligently managing his weight and adhering to a healthy diet, the male breast enlargement continued to worsen.

In 2024, after years of struggling with this condition, he scheduled a consultation with Dr Ivan Puah to discuss his concerns and explore potential solutions.

Consultation & Assessment

During his examination, Dr Puah assessed Mr F's condition and determined that he was dealing with Grade III gynecomastia. His condition is characterised by moderate breast enlargement that exceeds the borders of the areola. The edges of the breast tissue were distinct from the chest, and Mr F also had some skin redundancy.

Dr Puah explained that gynecomastia occurs when excess breast tissue forms beneath the nipple and areola, often pushing the nipple outward and creating a "puffy" appearance. In Mr F's case, this meant that his puffy nipples were not only prominent but also visible through fitted clothing.

Because he is experiencing physical symptoms such as breast tenderness that affect his daily activities and quality of life, Dr Puah recommended gynecomastia surgery. This procedure serves two important purposes: first, to reshape the male chest for a more masculine appearance, and second, to relieve him of physical discomfort while investigating any suspicious breast tissue that may require further evaluation. He emphasised the significance of understanding that the presence of excess breast tissue could potentially mask underlying issues that need further investigation.

After several weeks of consideration, Mr F decided to proceed with the gynecomastia surgery. Side effects, complications, and expected results were clearly explained to him, and blood tests were conducted to ensure that he was fit for the procedure.

Other Dr Puah’s patients with similar medical conditions

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• Singaporean Man Early 30s Finally Fixes Gynecomastia He's Been Dealing With Since A Teenager
• 32-Year-Old Indian Man Battling With Grade IV Gynecomastia
• Mid-40s Caucasian Man, Botched Gynecomastia Surgery
• Healthy Man 30s, Reduced Long Nipples with Nipple Reduction Surgery
• POV: Gynecomastia patient in Singapore
• Patient Shares His Gynecomastia Surgery Journey

Treatment Plan The procedure was performed at an accredited Day Surgery Centre under twilight sedation, with an anaesthesiologist closely monitoring Mr F's vital signs throughout the surgery.Dr Ivan Puah's 360° Glandular Tissue Dissection (360°GTD®) technique is designed to comprehensively remove enlarged breast tissue, resulting in a more masculine chest shape. 

This method ensures that the skin conforms naturally around the pectoral muscles, making it particularly effective for men with excess breast tissue and loose skin that may have developed over time.

One of the advantages of this technique is the strategic placement of the incision, which is positioned low on the areola. This location helps to create a discreet scar that is often difficult to notice. The excised breast tissue was fibrous, thick, and sizable, and it was sent for further histological evaluation.

In addition to addressing excess male breast tissue, Dr Puah uses his MDC-Sculpt® Lipo Technique to carefully remove unwanted fat, sculpting the chest to enhance its contours. This combined approach eliminates both breast tissue and excess fat, leading to a more defined and masculine chest profile.This thoughtful and refined approach to gynecomastia surgery provides lasting results without compromising natural aesthetics.

Post-Op Recovery & Results 

Following the procedure, Mr F was advised to wear a compression vest for eight to twelve weeks. This would help reduce swelling, support healing, and encourage his skin to retract properly. Just ten days later, his stitches were removed, and he could already see a change  in his chest shape. Most importantly, his physical symptoms of breast tenderness were alleviated.

Mr F is pleased to learn that his clinical condition qualifies for insurance coverage for this surgery, which is a significant financial relief for him. As the swelling subsided over the next three months, his results became even more noticeable, allowing him to wear fitted shirts with confidence.