Was the first thing you did when you received your Full-time National Service (NS) enlistment letter to look down at your chest? You have a few months to go before officially serving the nation, and as proud and eager as you are to be the backbone of Singapore’s defence, you are anxious and worried about your enlarged male breasts. On the Official MINDEF website, there is a dedicated page on how to prepare for NS. One of the pieces of advice provided is to “train up your fitness so you can hone mental resilience to deal with training better.” 

Getting physically fit for NS prepares you to adapt to the rigour of basic training as a recruit. It is much easier if you are physically fit and prepared for your Pre-Enlistee Individual Physical Proficiency Test (IPPT). If you are investing time and effort in training to get fit, kudos to you! We wish you the best in your NS journey. 

However, if you are working out daily in the hope of losing those enlarged male breasts you are embarrassed and worried about, we are sorry to share that this medical condition does not go away with exercise or diet because they are enlarged male tissues and not only fat. Unless, of course, what you have is actually pseudogynecomastia. Do you know that gynecomastia can look even more prominent as you lose weight? Here is a detailed breakdown of these two types of man boobs conditions, the different grades, how gynecomastia affects your self-esteem, and what can be done to get you ready for your NS journey in full confidence.

The Beauty Insider platform does not promote or support any specific treatment. The information provided in this article is for educational purposes only, and we strongly advise all readers to thoroughly research and consult with a doctor accredited by the Ministry of Health before undergoing any aesthetic or medical procedures.

Enlarged Male Breasts: Gynecomastia and Pseudogynecomastia

Gynecomastia is a common breast lesion that accounts for more than 65 percent of male breast disorders. Hormonal imbalances such as increased estrogen activity, decreased testosterone activity, or the use of certain types of medications to treat specific medical conditions are some of the common causes of gynecomastia. 

In certain instances (brace yourselves for this bad news, gym junkies), it can be a side effect of taking anabolic steroids. Gynecomastia is usually bilateral (affects both sides of the breasts), but it can also be unilateral (affects only one side), causing an obvious asymmetrical appearance.

Gynecomastia can be further classified into: 

  • True gynecomastia, where only glandular tissue is the cause 
  • Mixed gynecomastia, where both overdeveloped glands and excess fat are involved. 

Pseudogynecomastia, on the other hand, refers to a condition whereby fat accumulates on the chest. For this condition, exercise can have a significant impact, especially when accompanied by a healthy diet. When diet and exercise fail to produce any significant result, liposuction is recommended to permanently remove the unwanted chest fat.

Suspect You May Have Gynecomastia? 

There are self-evaluation methods which can be done to determine what you are facing. If you can feel a tender, firm and mobile disc-like mound of tissue when pressure is applied to your breasts, you might be suffering from gynecomastia.  

Another obvious sign is when the affected area resembles a female’s breasts. Other symptoms of gynecomastia may also include swelling, pain or soreness. ‍

Remember that you can only be 100 percent sure of your diagnosis by going for a proper and thorough physical examination by a doctor experienced in treating gynecomastia cases.

Gynecomastia in Teenagers and Adult Males

According to the National Institutes of Health, 50 to 60 percent of adolescent males suffer from gynecomastia. The symptoms of gynecomastia in younger people are usually caused by higher-than-normal estrogen levels in the body due to puberty. Although it is not unusual for the condition to regress over time, this is not always the case.  

Nearly 65 percent of men between 27 and 92 years old had some kind of gynecomastia. The reasons for gynecomastia in adolescents and adults are highly diverse, even though the symptoms are comparable. Adult gynecomastia is usually associated with increasing age due to progressive testicular hypofunction and, increased weight and body fat.

What is the Grading Scale of Your Gynecomastia? 

A classification from Simon, Hoffman and Kahn was adopted and is known as the “Gynecomastia Scale”. This scale enables gynecomastia doctors to standardise the discussion of issues and treatment of gynecomastia. Gynecomastia (True and Mixed) is universally classified into Grades I, II, III and IV, according to the severity of the breast tissue enlargement.

How Does Gynecomastia Affect Your Body Confidence During NS? 

The size of an enlarged male breast can go up to a C- or D-cup size. An oversized nipple-areola complex (puffy nipples) can appear distorted and look feminine. When the gynecomastia sufferer wears a form-fitting shirt, the breasts look like female breasts with some droopiness and loose skin. 

If you have man boobs, take a few moments to answer these questions sincerely and note your emotions as you think about your answers:

  • How does removing your shirt in front of others make you feel? 
  • Does the thought of your NS mates staring at your chest make you cringe, anxious and even angry? 
  • Do you feel that there is a possibility of being made fun of by your bunk mates for having a female-like chest?

Body dissatisfaction has resulted in a high percentage of males with extremely low self-confidence, anti-social behaviour and poor mental health and well-being. As men are more clammed up about their feelings and insecurities, they tend to take matters into their own hands. 

The pills or lotions that promise to reduce the size of your gynecomastia that you found online are nothing but a gimmick. Nothing you do, eat or apply can revert the enlargement of your breast glands; neither can fat freezing or low-energy laser, except for surgical intervention, in the form of gynecomastia surgery.

Dr Ivan Puah cited instances where male patients teared up as they shared the reasons behind their sense of low self-esteem. “In Singapore, the number of young adults who suffer from gynecomastia is high, and they usually will opt to have the affected glandular and fat tissues removed to relieve their symptoms before they report for enlistment. There is a sense of helplessness in them, and they want to know that you understand and can help them.” Studies have further substantiated his observation that men do not share their body insecurities with their peers or family.

How to Get Rid of Gynecomastia Safely and Permanently? 


Enlarged male breast glands removed during gynecomastia surgery

“Men who suffer from gynecomastia often feel ashamed of their body, but this medical condition is more common than you think, and there is no shame in seeking professional help to relieve the symptoms and improve the physical appearance of the chest. Thus, every process is important — from consultation, assessment and planning of the surgical approach to surgery and post-op care. Gynecomastia surgery can be impactful to the patient when it is done right. Therefore, it is crucial to consider the condition of each unique individual. No one gynecomastia case is the same, so it should not be done in a cookie-cut manner,” explains Dr Ivan Puah.

He concludes that gynecomastia surgery, like any other body contouring surgery, is 30 percent science and 70 percent art. It is a challenging procedure as it requires the doctor to apply the appropriate surgical technique, taking into account the degree of breasts droopiness, gland size, fat, and skin laxity to achieve an aesthetically pleasing result for patients.  

Post-surgery, the patient must don a compression vest to reduce post-tissue swelling and assist in skin retraction for about 4 to 6 weeks. Other than some restrictions with heavy lifting or gym work such as upper body chest works and water activities for a few weeks, the patient can return to daily activities without much hassle in a day or two post-op.  

Choosing the Right Doctor to Help You With Your Gynecomastia Issue

Wanting to proceed with surgery is an important decision. Choosing an experienced doctor with years of experience in surgical body contouring and checking out reviews is just one of the many important factors to consider. 

Clear Communication

During the consultation, the doctor should give you a clear and uncomplicated explanation and show you a variety of gynecomastia cases that he has performed. This will give you an idea of what to expect from your results. 

Be sure to discuss with the doctor your needs and goals. Choose an empathetic doctor with good bedside manners, who is confident and whom you are comfortable with.  

Quality, Experience & Trust Over Cost Of Gynecomastia Surgery In Singapore

Costs for gynecomastia surgery will vary between practices, and the following factors will determine the cost. In general, the doctor’s fees for performing gynecomastia surgery are based on their experience and the complexity of the case. 

Other charges include the type of anaesthesia used, hospital or surgical facility costs, medical tests such as blood tests, post-surgery garments, pre and post-medication, specimen (biopsy), etc. 

While costs are one of the variables you need to consider, the doctor’s experience and the variety of gynecomastia cases he has treated and your comfort level with him are just as important as the final cost of the surgery.  

Ensure that the doctor you choose performs the procedure in an accredited surgical facility with a team of well-trained surgical medical and support staff.