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Men seek breast reduction to get load off their chest

SINGAPORE — At 50, sales manager Peter Lee (not his real name) is proud of his trim 32-inch (81cm) waistline, which he has maintained over the last 20 years through a gruelling, thrice-weekly gym routine.

Before (left) and after liposuction (right), in which the patient had excess fat and breast tissue removed. Enlarged breasts in men, known as gynecomastia, affects about a third of all men over their lifetime. Photo: The Sloane Clinic Plastic Surgery Centre

Before (left) and after liposuction (right), in which the patient had excess fat and breast tissue removed. Enlarged breasts in men, known as gynecomastia, affects about a third of all men over their lifetime. Photo: The Sloane Clinic Plastic Surgery Centre

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SINGAPORE — At 50, sales manager Peter Lee (not his real name) is proud of his trim 32-inch (81cm) waistline, which he has maintained over the last 20 years through a gruelling, thrice-weekly gym routine.

But instead of flaunting his sculpted torso, Mr Lee has taken to hiding under baggy T-shirts — all because he has developed a pair of so-called man boobs. These “moobs”, as they are colloquially known, have grown over the last few years due to pockets of fat accumulating in the areas below and to the side of his nipples.

No amount of dieting and exercise could help him get rid of these moobs. So about three months ago, he paid about S$1,500 to undergo a non-invasive fat-freezing procedure to get rid of the stubborn excess fat.

“The rest of my body was in great shape, but that just made the moobs more obvious. They weren’t huge, but there was a noticeable jiggle when I ran. I hated it, and even started wearing baggier T-shirts to the gym,” he said.

 

A COMMON CONDITION 

 

Enlarged breasts in men, known as gynecomastia, are not an uncommon condition.

Some overseas studies suggest it affects at least a third of all men over their lifetime. But increasingly open attitudes towards cosmetic procedures and greater pressure to look good are driving more local men to seek treatment for their condition.

Plastic surgeon Tan Ying Chien said the number of such cases he sees at The Sloane Clinic Plastic Surgery Centre has risen by 15 to 20 per cent every year in the last five years; among them are an increasing number of men above the age of 40.

Some of the more severe ones have moobs large enough to fill a B-cup-sized bra.

“I used to see younger gym-going men in their 20s who want to surgically remove some fat and breast tissue so that their pectoral muscles could show better. Now, I’m seeing more men in their 40s and 50s. Many of them are working professionals who want to look presentable, and are self-conscious when their moobs are visible through their T-shirts,” said Dr Tan.

Dr Calvin Chan of Calvin Chan Aesthetic and Laser Clinic, who carried out the fat-freezing treatment on Mr Lee, sees an average of three to five male patients each month, a trend that picked up in the last two years.

Before that, he did not see such cases. “These men tend to be established in their careers, with families, but are pressured by their wives to look good, particularly if the women have embarked on diet and fitness regimens, and aesthetic treatments to maintain their figures,” said Dr Chan.

A male chest-reduction procedure typically involves using advanced liposuction techniques that break down excess fat either through ultrasound energy or radio-frequency energy, and then removing the fat via vacuum suction, said Dr Martin Huang, director and plastic surgeon of MH Plastic Surgery.

The procedure may cost between S$6,000 and S$15,000, depending on the technique used and the amount of tissue removed, he said.

During the procedure, the surgeon may also remove breast tissue via a 1.5cm- to 3cm-incision, said Dr Tan.

The availability of a relatively new non-invasive, non-surgical fat-freezing procedure has also allowed some patients to get rid of excess fat without going under the knife.

The technique, known as Cool-Sculpting, uses a device that freezes fat cells to death, after which the dead cells are gradually removed by the body’s immune system over a period of one to three months, said Dr Huang. Costs vary from S$3,000 to S$8,000 depending on the amount of tissue that needs to be removed and the number of sessions required.

Dr Chan said the best candidates for this treatment are those who are at or near their ideal body weight, but have stubborn fat that will not budge despite a balanced diet and exercise.

But Dr Tan said the effects of this method are “limited” on moobs as it does not reduce the breast glands in men, which liposuction addresses.

 

A SIGN OF SOMETHING

MORE SINISTER?

 

Similar to women, men have breast glands, but they are not normally noticeable because they remain small and undeveloped, said Dr Huang.

He added that swollen breasts become more common when men approach middle age and beyond, and produce less of the male hormone,testosterone.

They are also likely to be overweight and less active than younger men, which aggravate the problem as excessive weight may lower testosterone levels and increase the female hormone, oestrogen.

Besides, the increasing incidence of obesity means that a significant portion of men with enlarged breasts have a “pseudo” form of gynecomastia, said Dr Mok Shao Feng, an associate consultant at the Division of Endocrinology at National University Hospital.

This condition occurs due to increased fat accumulation rather than the abnormal growth of breast glands.

In some cases, enlarged breasts in men may signal something more sinister. For instance, a physical breast examination may reveal signs like a hard and immobile breast lump, which may suggest a possible malignant disease, said Dr Mok.

Other possible causes include hormonal problems, side effects of medications or organ damage such as kidney or liver failure, he added.

According to Dr Huang, some researchers suspect the moob-development trend is linked to the increased exposure of pseudo-oestrogens (compounds that mimic the female hormone oestrogen) in certain food and environments, which can influence fat production and hormonal imbalance.

Oestrogen-friendly foods include soya bean milk, flaxseed, beans, peas and alfalfa sprouts, while environmental pseudo-oestrogen is present in common everyday items such as plastics, cosmetics, cans and pesticides, he said.

While cosmetic procedures might offer a quick fix, Dr Mok said men who experience breast enlargement should first see a doctor who will perform a thorough history and physical examination to ascertain its underlying cause.

Dr Tan said those suspected to have an underlying medical cause are usually sent for further screening and blood tests.

“If an underlying medical cause is identified, the treatment is directed at the specific condition before surgical intervention is considered.

“For example, men found to have inadequate testosterone levels may receive testosterone replacement as treatment, or certain culprit medications may be discontinued to see if the gynaecomastia resolves spontaneously,” said Dr Mok.

When no other identifiable causes are found after a thorough medical check-up, surgery to reduce the volume of breast tissue may be considered by men who are distressed by persistent gynaecomastia, he added.

For those who are not disturbed by the physical changes, the enlarged breasts may be left alone.

But ageing naturally is not an option for image-conscious men like Mr Lee, who has regained his self-confidence after the treatment.

He said the procedure has helped reduce the size of his moobs by around 35 to 40 per cent, and he is contemplating a second round of treatment “to complete the job”.

“I’m definitely more comfortable jogging in a T-shirt or wearing a singlet at the gym now. I don’t even mind going swimming any more,” he said.

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