Dr. Ivan Puah has spent more than 15 years performing FDA-approved injectables, skin lasers, and body sculpting surgical procedures. From his patients’ diverse concerns, he predicts the cosmetic surgery trends for 2020.
SINGAPORE, Jan. 22, 2020 /PRNewswire/ — Dr. Ivan Puah, Medical Director of Amaris B. Clinic, who is accredited by the Ministry of Singapore to perform surgical body sculpting treatments, has seen a plethora of diverse concerns from 25- to 65-year-old male and female patients in Singapore.
1. Rejuvenation Biostimulation Is The Treatment That Is Getting Popular With The Advent Of Tech Device Usage
As more people rely and get subconsciously overly fixated on their modern communication devices such as smartphones and laptops, Dr. Ivan Puah has noticed a rise in the case of Text Neck. Text Neck describes the pain and damage sustained on the neck and shoulders from looking down at one’s device for an extended period. The physical stress causes skin damage on the neck leading to visible deep horizontal lines across the neck.
One of the most effective treatments for this is a treatment called Rejuvenation Biostimulation. It is the use of hyper-diluted calcium hydroxyapatite fillers that stimulates stem cells into regenerating collagen in combination with the use of energy devices that produces focused ultrasound energy. “These combined modalities can effectively improve facial and necklines as it encourages skin rejuvenation,” Dr. Ivan Puahsaid.
2. Gynecomastia, or Enlarged Male Breasts, Is More Common Than You Think
Gynecomastia occurs when excess glandular tissue is produced. When an abundance or excess fat appears in the chest area, it is known as pseudogynecomastia (fake/faux gynecomastia), which can be treated with liposuction alone. “In my experience, most patients who complained of pseudogynecomastia are later found to have true gynecomastia after medical assessment,” shared Dr. Puah.
“Due to the high volume of patients I see regarding their gynecomastia concerns over the years, I have designed a customized 4-step gynecomastia surgery program called 4D Chest Remodelling. It reduces fat tissues and removes excess glandular tissues while stimulating the production of subdermal collagen to induce tissue remodeling and production of new collagen and elastin.” Unlike the standard gynecomastia surgery, 4D Chest Remodelling is a more complex treatment modality especially planned for those whose ultimate objective is to achieve a flatter and sculpted chest using high definition body sculpting technique.
3. Nose Enhancement With Thread Lift Is Gaining Fast Popularity
Nose Thread Lift is quickly becoming one of the more sought-after treatments when it comes to achieving a more natural appearance. It is a treatment that is surpassing the popularity of nose fillers when it comes to non-surgical rhinoplasty. “The reasons for the decline in popularity of nose fillers include complications and migration of fillers,” said Dr. Ivan Puah.
HIKO Nose Thread Lift uses absorbable PDO thread to achieve a higher nose bridge without the need for surgery. These threads are placed carefully in the nose to heighten the nose bridge. Dr. Puah added, “PDO material has been in use for more than 30 years in various medical disciplines such as plastic surgery and gynecology treatments because of its high tensile strength, good pliability, and smooth tissue passage.
4. Natural Look & Customised Treatments Are Much Preferred
“Unlike the past where many preferred dramatic results, my patients today are opting for treatments that produce natural-looking results. This includes facial and body enhancement treatments with fat grafting,” shared Dr. Puah.
Facial Fat Grafting’s goal is to restore lost volume to the face, which is often associated with youthfulness. It uses a patient’s own fat tissue, in tiny amounts, removed from excess fat pockets and then injected into areas of the face where needed.
For fat grafting on the body, ADR-C Breast Enhancement is popular among women who are looking to add volume to their chest while removing stubborn pockets of fat on the body. It works by removing fat tissues using the micro-lipo technique from parts of the body where there is a substantial amount of fat, such as the abdomen or saddlebags. The fat is centrifuged to maintain the integrity of the fat cells and then injected into the areas in the breast where the volume is lacking.
5. Hourglass Body Shape Is Out. Toned Body Is In
The hourglass body shape, as commonly seen in the media, is one of the body types that most women covet. “In Asia, however, the hourglass body shape is not the preferred body shape but the toned body is,” said Dr. Ivan Puah. Hourglass body shape comprises of a pair of voluptuous breasts, a small waist, and curvaceous hips. He added, “Many Asian women do not like heavy bottoms as it resembles a pear shape and they have instead expressed their preference for the toned and proportionate look – one that complements their frame and height.”
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ABOUT DR. IVAN PUAH
Dr. Ivan Puah is the medical director of Amaris B. Clinic, a medical aesthetics clinic in Singapore. He obtained his VASER® Body Sculpting training in Colorado and Argentina. Additionally, he also received training and guidance in syringe liposculpture, fat grafting, and thread lift by renowned French plastic surgeon, Dr. Pierre Francois Fournier. He further honed his surgical skill in gynecomastia surgeries in San Francisco. In Singapore, Dr. Ivan Puah is accredited by the Ministry of Health to perform surgical body sculpting procedures. Dr. Ivan Puah holds a Graduate Diploma in Family Dermatology from NUS and Graduate Diploma in Acupuncture from TCMB. He is also the appointed trainer on Botulinum Toxin and Dermal Fillers for Merz, Newton Cog Thread, and PICOCARE Laser from Venusys Medical.
OTHER SIGNATURE AESTHETICS & SCULPTING TREATMENTS AT AMARIS B. CLINIC
Started in 2004, Amaris B. Clinic has been providing medical aesthetics and body sculpting services. Amaris B Clinic’s forte lies in body sculpting – surgically removing stubborn fat pockets to sculpt and shape different areas of the body through a variety and combination of services offered. Amaris B. Clinic received recognition as the “2019 Body Sculpting Provider of the Year in Asia Pacific” by Global Health and Travel. The clinic’s signature treatments include:
Typical Journey of a Gynecomastia Patient: Gynecomastia Surgery Cost In Singapore.
Typically, a guy who is unhappy with the size and shape of his breasts and nipples and who has been suspecting that he may have gynecomastia, will call up or write in to enquire about treatment options for his condition. We will then set up a consultation appointment for the patient.
The surgery will usually take about an hour and the patient will be able to return home to rest after the treatment. No hospitalization is required.
Based on our experience, patients will be able to perform most of their daily activities within 1-2 days post treatment. However, most will require up to 2 weeks to resume rigorous activities such as sports and gym work-out.
Our medical team will follow our patients’ recovery for the next 3 months. For some patients, skin tightening and scar treatment may be offered during this recovery period to help optimize their results.
Gynecomastia Surgery Cost
In Singapore, the procedure may cost between S$6,000 and S$15,000. What constitutes to $6000 and what constitutes to $15000?
Treatment required will depend on the condition of the affected patients. For instance, gynecomastia can be classified into different categories based on gland sizes, surrounding fat layers, and skin laxity. The treatment options, approach, and complexity may vary. Strictly speaking, there is no ‘one-size-fit-all’ treatment for gynecomastia.
An interesting question I have been asked before is that “Since gynecomastia is on breasts reduction for men, can women go for it too?” Breast gland reduction for male gynecomastia is different from breast reduction surgery for females.
Liposuction may be helpful for women with excess fatty breast layers, achieving a certain degree of reduction, sculpting and lifting. Do note that women with significant breast hypertrophy may ultimately require breast reduction surgery.
The cause of “physiologic” adult gynecomastia is not known, and it is likely to be multifactorial. One of the possible factors is the age-related declines in serum testosterone after 30 years of age in males.
The answer to the common question of “Can gynecomastia cause low testosterone?” is that gynecomastia does not cause it, but conversely, it may possibly increase the risk of developing gynecomastia in males.
Does gynecomastia reduce libido?
Low testosterone level reduces libido, not gynecomastia.
Does gynecomastia contribute to low sperm count?
Low testosterone, not gynecomastia is one of the many possible causes of low sperm count.
Does gynecomastia result in erectile dysfunction?
Gynecomastia does not result in erectile dysfunction directly. It is not uncommon for patients who suffer from gynecomastia to have low self-esteem, social phobia, anxiety and even depression. Those psychological issues, if persistent and severe, may cause patients to suffer from erectile dysfunction.
The relationship between low testosterone and gynecomastia
Gynecomastia is a complex process resulting from many hormonal changes in the body. Estrogens strongly stimulate, and androgens, weakly inhibit breast gland growth. The imbalance between estrogen actions relative to androgen action at the level of breast tissue is believed to be the main etiology. Various hypotheses have been put forth to explain the etiology of gynecomastia, including: elevated estrogen levels; lowered free testosterone; abnormal testosterone-to-estrogen ratio; increased peripheral conversion of testosterone to estrogens . However, for most patients, the etiology still remains unclear.
In addition to treating gynecomastia, you may want to treat it
Testosterone levels in men tend to decline with age. Patients with testosterone levels require a thorough medical evaluation. Clinical assessment and lab investigations are required to identify possible underlying causes such as medical illness, lifestyle or ageing factors. If there are underlying causes for this, the patient will be referred for individualized treatment for these causes.
The testosterone levels can be supplemented by hormones prescribed by a doctor. Regular follow up will be required for the patients.
Some may think their enlarged male breasts are due to weight gain but most of my male patients have a combination of both. Can fat freeze cure your enlarged male breasts?
Nothing can fix gynecomastia except for gynecomastia surgery?
You are probably suffering from pseudogynecomastia. What is pseudogynecomastia?
“Man-Boobs” or male breast enlargement can be due to breast tissue hypertrophy (gynecomastia), fat tissue hypertrophy (pseudogynecomastia) or a mixture of both. Most of my patients (75%) suffer from a combination of both, 20% of them had only gynecomastia, and less than 5% had pure fat hypertrophy or pseudogynecomastia. It is relatively uncommon for patients to only have pseudogynecomastia when they present with symptoms of breast enlargement.
Fat Freezing for men’s breast tissue: How Does fat freezing Target Fat in Men’s Breasts?
Fat reduction treatment such as fat freezing uses a controlled cooling mechanism to ‘freeze’ targeted fat tissues. This will lead to damages to the fat tissues. The ‘injured’ or damaged fat tissues will then be removed from your body.
Fat freezing can be effective for pseudogynecomastia in some male patients. How does it work?
For those who are not ready for surgical treatment, fat freezing is probably the next best option for pseudogynecomastia. However, you will need to have a realistic expectation as Fat Freezing may reduce only up to 20-25% of existing fat tissues. For patients who do not respond to the treatment, breast liposuction will have to be considered next.
You will need to be evaluated first to know if you are a good candidate for treatment. Who makes a good candidate for gynecomastia? Who makes a good candidate for pseudogynecomastia?
As mentioned earlier, 90-95% of the patients with ‘man-boobs’ that I see have some degrees of breast tissue enlargement, with and without associated fat tissues. These patients will not respond well to fat freezing or fat reduction alone. Just reducing the fat tissue alone, may lead to unsightly results such as puffy nipples, asymmetry, and so on.
It is crucial to have the right diagnosis before subjecting patients with male breast enlargement for Fat Freezing treatment, as only a small percentage of the patients will truly benefit from it.
What happens during the fat freezing procedure?
It will be performed with the patient lying comfortably on a bed. The specialised membrane will be applied on the chest to protect the skin from cold before applying suction paddles to the treatment areas. Then, using controlled cooling, fat tissues will be cooled till they crystalised. The whole treatment will take approximately an hour.
Abstract of original forum post: There is no answer for who is the best gynecomastia surgeon? The real question is who is the best gynecomastia surgeon for you! The price of male breast reduction surgery is quite variable and depends on many factors. One price does not fit all patients. Read on to find the best ways to choose the right surgeon at the best price for your gynecomastia surgery.
Choosing the Best Surgeon for Gynecomastia Treatment
The best gynecomastia surgeon for any person depends on many factors. The surgeon should be a Board Certified Plastic Surgeon or the equivalent in other countries. This shows that he or she has had extensive plastic surgeon training and has passed the intensive testing to be certified. In the United States, being a member of the American Society of Plastic Surgery and the Aesthetic Society of Plastic surgery, are the highest education honors and displays specialty in cosmetic surgery. Gynecomastia is a cosmetic procedure to make a man’s chest look great and aesthetics is critical. The gynecomastia tissue is not cancer! This surgeon should do a significant number of gynecomastia reduction surgeries on a frequent basis.
Gynecomastia Surgery Costs and Tips to Avoid Needing a Second Surgery
The price of gynecomastia surgery is somewhat complex. There are no set prices and a gynecomastia expert will, in general, be more expensive than a surgeon who does not do this often. When selecting a surgeon, price is one of many factors so do not select a surgeon only on cost. In my personal practice, 40% of my gynecomastia surgery is revision surgery on men who are not happy from other practices who now have to, unfortunately, pay for a second surgery.
5 Tips for Selecting Your Perfect Gynecomastia Surgeon
In selecting a gynecomastia surgeon these are some important factors to evaluate
A solid consultation where you feel comfortable with the doctor’s knowledge and thoroughness and kindness of the staff.
Documentation of his or her work by many before and after photos.
5 Factors to Consider When Looking at the Costs of Gynecomastia Surgery
The price of surgery is determined by many factors :
Grade of the Gynecomastia – There is severity of a man’s gynecomastia and it is made up of grades 1-4. So as the grade increases so does the complexity and the time that the surgery will take. This adds up to more expensive.
General vs Local anesthesia – The cost between the two are greatly different. I, personally, only use general anesthesia and there are many reasons for this decision. Some surgeons market local anesthesia very heavily.
Revision gynecomastia surgery – A gynecomastia surgical expert see’s many of these patients. They can be simple to correct or impossible. It may take multiple surgeries. The cost is determined by the complexity.
Location of your surgery – Certain cities cost a premium because of the expenses in that location to run a business. For example, New York City or San Francisco will cost more than a much smaller city or remote area.
The expertise of the surgeon.
4 Gynecomastia Grades to Look at Before Choosing a Surgeon
The photos below show the grade or severity of gynecomastia. As the grade goes from 1-4 the complexity and time to perform the surgery does as well.
THE GRADES BELOW ARE GRADES 1-4
Grades of Gynecomastia | Gynecomastia.org
Ways to do Your Research Before Choosing a Gynecomastia Surgeon
When selecting a gynecomastia surgeon who is “BEST FOR YOU” it is critical that you do your homework or research. This is a very important journey in your life and getting it right the first time will save you a lot of headaches. Visit a few doctors and don’t be afraid to travel if there is not a good choice in your area. This is an easy procedure to have performed in a distant location. Do not let price alone determine your choice.
If we look at some general costs. If we start at Grade 1 the surgery fee may be $3,500 and add $1,000 for each additional grade of severity. So the surgeons fee for a grade 1 patient may be $3500 and the grade 4 may be $6500. When you calculate the surgery center and anesthesiologist this is a function of time. Grade 1 will cost less and Grade 4 more. These fees are highly variable from place to place. In my surrounding bay area anesthesia is 300 per hour or more and surgery center is on average 800 per hour or more. So the Grade one case which takes say 2.5 hours would cost $6250 and a Grade 4 which takes 4 hours $10,900. These are very general but the point is the surgery varies a great deal. There are other more advanced procedures for the Grade 4 cases which require a free nipple mastectomy which cost significantly more, see below.
Grade 4 which requires a mastectomy:
This procedure involves: * double incision mastectomy – this removes the extra skin. * resizing and relocation of the nipple-areola complex to a more masculine location. * possible extension, like in the case, to around the back. * scar management.
Final Points When Looking at Price or Surgeons for Your Gynecomastia Procedure
Do your homework and select your surgeon carefully but with great confidence and belief. Cost is important but not the most important criteria.
For personalized information about gynecomastia plastic surgery procedures, please complete Dr. Delgado’s inquiry form.
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