gynecomastia vs pseudogynecomastia?

[King_kaboodle]

So now Im kinda curious if I instead have pseudogynecomastia, but I havent found any sure fire ways of testing. >_> Any ideas? =D

[ddaavviiddd]

6'3" sounds normal to me.  but keep trying to lose body fat and put on muscle and see what happens

[Paa_Paw]

I do not like the distinction between real and pseudo Gynecomastia.

The effects are rarely physical but almost always psychological.

That said, Fatty tissue is usually soft while glandular tissue is more fibrous. Don't put too much stock in this, However, as the difference can sometimes be so subtle that it is almost impossible to distinguish.

The breast area is a normal place for fat to deposit. For some of us, it seems to be the first place where we put it on and the last place where it can be lost. It is possible for many men to lose weight to an unhealthy degree without losing the pad of fatty tissue in the breast area.

Glandular tissue, being fibrous, is not affected by weight fluctuations.

Your statement that the breast size changes with gain or loss of weight would suggest that you simply have an embarassing pad of fat.

Usually, there are fingers or threads of fibrous glandular tissue in and through a pad of fat.

[DrBermant]

What do you think the best way to tell the difference between the two is?

Im 6'3", 215lbs. I wear size 36-38 pants, give or take. Not obese but Ive got some extra pounds I'd love to shed.

The reason I ask is because I always thought I had gynecomastia. Yet as I lose weight, tho it is slight, Im noticing a decrease in the size of my chest as well. Plus, while my chest is larger than most mens I dont find that it looks like 90% of the pictures Ive seen which mostly resemble female breasts.

So now Im kinda curious if I instead have pseudogynecomastia, but I havent found any sure fire ways of testing. >_> Any ideas? =D

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.

Losing weight first, to something you are comfortable with and can maintain is typically a much better option.  Weight loss is a coarse tool.  Unfortunately, you cannot pick where weight comes from - nor can you pick where weight goes back on to.  Gland that contributes to the breast shape is not helped with weight loss.  Fingers of fat in the gland can become smaller, but the contour problem from gland does not go away.  After losing weight plastic surgery can help with localized fat, gland, and extra skin.  After surgery remaining fat cells can put on more weight.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture