Do I have Gynecomastia?

[SOADFAN]

So I've been overweight a good part of my life.  And with that came the "man boobs."  But I'm just wondering how I can tell if its just fat or Gynecomastia without having to go to the doctor.  If i need to post pics i will.

[DrBermant]

So I've been overweight a good part of my life.  And with that came the "man boobs."  But I'm just wondering how I can tell if its just fat or Gynecomastia without having to go to the doctor.  If i need to post pics i will.

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

[Paa_Paw]

The good Doctor has stated it very well.

His important caveat is that significant weight loss should precede rather than follow surgery.

The Surgeon is always concerned and wants his patient to be happy with the result. The person with the greatest responsibility is the patient himself.  To achieve the very best result, you need to be a good patient. Accept a certain amount of responsibility for yourself.