Man boobs or "moobs" is a condition that affects many men in Singapore. It causes a lot of social embarrassment for patients as they are afraid of removing their tops or wearing tight T-shirts in public places. Some patients may even experience pain or discomfort as a result of this enlargement.
The causes of gynecomastia may be briefly divided into four. They may be Physiological, Pharmacological, Pathological or Idiopathic in nature. Physiological gynecomastia happens to patients during their infancy, teenage years or during old age. There is usually no need for treatment as the gynecomastia here is usually temporary and is due to the hormonal surgery during these periods in time. Pharmacological causes of gynecomastia includes consumption of various drugs including anabolic steroids, certain anti-ulcer medication or heart medication. Treatment for this group of patients includes switching to alternative medications if possible. Very rarely, gynecomastia may be a result of certain hormone-producing tumours including testicular tumour or brain tumours. Treatment for this group of patients involves treating the underlying cause. By far, the most common cause of gynecomastia we see is idiopathic in nature, meaning there is no known cause. These patients respond well to surgery with low recurrence rates.
Surgery is by far the best treatment for gynecomastia. Surgery can be divided into the “scarless” approach or the “open” approach. The “scarless” approach entails a 4 mm small cut on the side of each breast. Then, liposuction is used to remove the fatty tissue and a special device known as the microdebrider is used to remove the fibrous glandular tissue. This is a day plastic surgery procedure and takes around 1.5 hours. Patients can resume their normal activities after 1-3 days. This approach is suitable for patients with gynecomastia but without significant skin excess.
For patients with skin excess, the “open” approach using a small periareolar incision is best. The scar is not obvious as it is placed exactly at the junction of the areola skin with the breast skin. This method allows excision of the gynecomastia and removal of any loose skin. Again, this is also a day surgery procedure and takes between 1-3 hours. Recovery is 1-4 days.