Gynecomastia? Or chest fat? Or Puffy Nipples?

[ap1234]

Hey guys,

I'm wondering whether I have gynecomastia or just puffy nipples and chest fat. Does chest fat cause puffy nipples? I'd say my body fat percentage is somewhere between 15-20% not sure exactly. I've uploaded a bunch of photos on this album :


This forum won't let me link to image shack
  but heres the album : ----imageshack.us/user/ap123428

or try this link

    ----http://imageshack.us/g/252/img1141i.jpg/

I characterize myself as skinny fat. I have very slender wrists but fat around my stomach/chest/hips. Some of the photos show me flexing my chest as much as possible and if you carefully enough you can see a sort of mass to the sides of the nipple. Not sure if thats fat or breast tissue. I don't particularly feel any lumps or things around the nipple, but If I palpate around the sides I do feel some sort of band. Not sure if that is adipose tissue/muscle/breast tissue or just made up in my head.

When I pinch my nipples, come out of the shower, or am in a cold area the nipples lose the puffiness and begin to look normal. Do you think I'll get that normal look if I just loose some more fat? I'm like 5'11 161 lbs. Also I'm 21 years old so I don't think its puberty gyno. Does having puffy nipples automatically mean you have gynecomastia? Or can other things cause puffy nipples? Like the chest fat I have?


Here are some key photos that really show the pointedness/puffy nipple look:













this last one shows me flexing.

Please use the album links above to get a better idea. I know its not easy to diagnose off of pictures but I took a lot to make it easier.

Thanks in advance!

[DrPensler]

After looking at the first photo, you have gynecomastia.

[ap1234]

Really bummed...:/ I was hoping losing fat would fix it.

Is there anyway I can reduce the puffiness and pointiness without surgery?  What usually constitutes a gynecomastia reduction surgery that is covered by insurance? Will the surgery rectify my situation for life?

Is it possible for this condition to worsen over time? If so would waiting for surgery be better or worse?

[Litlriki]

There aren't any non-surgical means to correct gynecomastia of the sort demonstrated in your photos.  My approach involves liposuction as well as direct excision of the tissue under the nipple/areola.  In patients who develop gynecomastia during puberty, the results typically last a life-time unless other factors contribute to recurrence (medication, steroids, weight gain, etc.)  As far as insurance coverage, that is rare in my experience, at least in Massachusetts.  Regarding timing of the surgery, for most patients who are able to proceed with correction, the sooner the better--because many struggle with other aspects of life until their chest is normal in appearance.  If stable weight is maintained, the condition doesn't typically change after it's established through puberty, but it might worsen with weight fluctuation, since the fatty component can increase.  Also, other facts (medications or steroids, for example) could cause it to worsen.

Rick Silverman