Surgical Management of Gynecomastia in Asian Men - Clinical Experience and Considerations for Different Patient Types

Gynecomastia, the excess growth of glandular breast tissue in males, is a common condition associated with hormonal imbalance or the use of certain drugs. Although medically benign, persistent gynecomastia often causes psychological distress and adversely affects quality of life. Published literature on the evaluation and management of patients seeking surgical treatment for gynecomastia is predominantly from Western populations. Here, we present insights from our practice in a multi-ethnic Asian population, with >550 cases treated at Amaris B. Clinic, Singapore from 2018-2023. We illustrate these insights and principles with a representative selection of 6 patient cases. We discuss specific considerations for optimizing the consultation process and outcomes in Asian patients, with reference to profiles commonly seen in our local setting. These were: adult males, the most encountered patient profile who are typically overweight/obese; young (adolescent) males, typically overweight, had a history of recent significant weight loss, or lean and experiencing gynecomastia due to puberty-related hormonal changes; males with drug-induced gynecomastia, typically athletes/bodybuilders. Our experience highlights several important considerations, including management of the consultation process, the range of patient expectations, and addressing surgical aspects of management to achieve the desired aesthetic outcomes.