Singapore Study on Gynecomastia Surgery in Asian Men Reports High Patient Satisfaction with Tailored Surgical Techniques
Key Insights
A study covering over 550 gynecomastia (search) cases treated between 2018 and 2023 at Amaris B. Clinic (search) in Singapore demonstrates effective surgical management tailored to Asian men.
Five of six representative patients reported no complications at 3-month follow-up and rated satisfaction a perfect 7 out of 7, with relief from emotional distress.
Dr. Ivan Puah emphasizes that Asian patients require adapted surgical techniques due to differences in skin quality, scarring tendencies, and hyperpigmentation compared to Caucasian patients.
A new study led by Dr. Ivan Puah, Medical Director at Amaris B. Clinic (search) in Singapore, has demonstrated that tailored surgical techniques for gynecomastia (search) in Asian men yield high patient satisfaction and low complication rates. The research, published in the World Journal of Plastic Surgery under the title "Surgical Management of Gynecomastia in Asian Men - Clinical Experience and Considerations for Different Patient Types," draws on over 550 cases treated between 2018 and 2023, offering one of the most comprehensive analyses of gynecomastia surgery in a multi-ethnic Asian population to date.
The evaluation and management of surgical treatment for gynecomastia (search) have historically focused on Western populations. Dr. Puah's research addresses this gap by providing detailed considerations specific to Asian patients, including the management of the consultation process, addressing varying patient expectations, and tackling the surgical aspects necessary to achieve desired aesthetic outcomes.
Diverse Patient Profiles and Etiologies
The study presented six representative patient cases illustrating the demographics and unique challenges faced by Singapore's multi-ethnic population. Patient profiles included obese, overweight, and lean adults, as well as adolescents. The cases spanned Chinese, Malay, and Indian ethnicities, with ages ranging from 17 to 46 years.
Common causes of gynecomastia (search) observed across the patient cohort included hormonal changes during puberty, drug-induced gynecomastia from anabolic steroids (search), and conditions related to weight loss. Two adolescent patients, aged 17 and 18, presented with bilateral breast enlargement since ages 13 and 12, respectively. Among adult cases, a 22-year-old Malay patient had used anabolic hormone supplements for bodybuilding over four years, while a 46-year-old Chinese patient had taken anabolic steroids for five years. Two patients with Grade IV gynecomastia—a 28-year-old Chinese and a 21-year-old Indian—had been overweight since childhood and experienced no reduction in breast enlargement despite losing weight, with skin laxity present in both cases.
Proprietary Surgical Approach
Dr. Puah's surgical methods involve making a single incision along the areola to minimize scar visibility while effectively excising glandular tissue, performing liposuction to remove excess fat, and tightening the chest skin. This approach is specifically designed to address the anatomical and dermatological characteristics of Asian patients.
"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," Dr. Puah stated. "The differences in skin quality and glandular tissue characteristics between Asian and Caucasian patients with gynecomastia (search) necessitate distinctions in treatment planning, particularly regarding careful incision placement."
Outcomes and Patient Satisfaction
At the 3-month follow-up after surgery, five of the six patients reported no complications, highlighting the effectiveness of the tailored surgical approach. These patients 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. The keloids were not easily noticeable, and the patient reported no complications or dissatisfaction with the overall outcome.
The findings underscore the importance of adapting surgical techniques to the specific needs of Asian patients, where scarring and pigmentation concerns can significantly impact aesthetic outcomes and patient satisfaction. The full paper is available via the World Journal of Plastic Surgery.