pseudo gynecomastia

[balalayka]

Hi all,

Now I've seen some cases, where the gyno is mostly fat (I'm one of them). The problem is that this chest fat never seems to respond to diet or exercise (my case). I was 1.80 cm tall and went on a strict diet, very strict that I got underweight, to 67kg. Even at this weight, my breats were large! Anyway, I'm back to normal weight now and I go to the gym regularly. I managed to improve the contour of my chest using bench presses , however, the fat is still there and won't go away. There must be some scientific reason as to why fat on the male chest is very stubborn and simply cannot be gotten rid of. Does anybody have an explantion as to why chest fat is so stubborn? Maybe one of the docs on the forum can help.

[DrBermant]

Hi all,

Now I've seen some cases, where the gyno is mostly fat (I'm one of them). The problem is that this chest fat never seems to respond to diet or exercise (my case). I was 1.80 cm tall and went on a strict diet, very strict that I got underweight, to 67kg. Even at this weight, my breats were large! Anyway, I'm back to normal weight now and I go to the gym regularly. I managed to improve the contour of my chest using bench presses , however, the fat is still there and won't go away. There must be some scientific reason as to why fat on the male chest is very stubborn and simply cannot be gotten rid of. Does anybody have an explantion as to why chest fat is so stubborn? Maybe one of the docs on the forum can help.

Gynecomastia comes in many different sizes, shapes, and forms.  Unfortunately, it can be difficult to distinguish just what is causing the problem.

Men tend to put fat on first their chest and belly regions.  We take it off there last.  Unfortunately, it can be difficult to distinguish just what is causing the problem.  Gynecomastia male breasts can be fat, gland, or most commonly a combination of both.  Sometimes skin and sagging tissues can be a factor.  Pseudo Gynecomastia is supposed to be fat only gynecomastia.  The problem with that "classification" is that in almost every case of gynecomastia I have seen there is some component of gland.  This gland can be very small, but it is present almost all the time.  So do you have Pseudo gynecomastia when there is a 1%, 10%, 50%, or 90% deformity from fat?  Reality just does not work that way.

Defining the problem with photographs sometimes can help.  However, it is impossible to tell from photographs if the deformity is from fat or gland. The dynamic images, of my standard set of images can show a region that compresses differently.  Even clinical examination differentiation can be difficult.

Fat tends to be soft, gland tends to be firm.  Fingers of gland often dissect between fingers of fat.  Look at this drawing and move your mouse over the arrows.  However, gland can be soft and fat firm confusing the picture.  Gland tends to be located under the nipple and pinching pressure can sometimes tether to the nipple pulling it in.

Men with excessive fat do tend to have certain contour issues.  Check out this link about Sumo Wrestlers.  Men tend to carry excessive weight in their chest and stomach.

Weight Loss Before Surgery is typically better than weight loss after surgery.  Losing weight is a coarse tool.  Plastic Surgery is best reserved as a refinement tool.  You cannot pick where the weight comes from, nor goes onto.  Men typically gain weight first on the stomach, love handles, and chest.  We typically take weight off the same areas last.  Major weight loss after surgery may not come from your chest.  If like most men, you do not lose as much from the chest, it may look as if your gynecomastia has recurred.  Some of my patients loose their weight after surgery and get away with it.  However, weight loss after surgery is a gamble.

Getting to a weight you are comfortable with is often best.  Taking weight off, having surgery, and then putting weight back on is a problem.  If as with most men, weight is put on the breasts, it can look like the gynecomastia has come back.

After major weight loss, there may be loose drooping tissues.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture