Still not sure if this is just fatty flab?

[Salsoul]

Hi, it's been 5 years since I last posted here, seeking advice.
Here are some recent photos.
Since returning to work 18 months ago after some time off I've been very aware of how I look in my work uniform shirt, my breasts look more obvious than ever before.
Since I last posted my weight has been up and down but I do exercise but my breasts never seem to change.
If I lose weight from my stomach they again seem more pronounced.
I did previously experiment with compression vests and sports bras but gave up after a while as I thought this might have just been flabby fat after all, but now I'm not so sure again as even at my fittest my breasts were still flabby and would bounce during exercise especially running.
Any observations and views would be greatly appreciated. Thanks.

[Parity]

I certainly don't want to diagnose looking at pictures.  People put on weight differently.  People loose weight differently. 
With out a Dr. looking, Squeezing and testing I feel you may not get the correct answer.  

[Jamie325]

From one overweight guy to another, lose the weight and you will look better and feel better.  For the sake of my increasing my stamina and energy, I've gone from 221 lbs.to 197 lbs.  I feel a lot better.  Although my boobs are smaller, they are still noticeable because my waist shrunk even more.  No problem.  Even when I was my ideal weight of 175 lbs., I had a fleshy chest.  

[Justagirl💃]

I certainly don't want to diagnose looking at pictures.  People put on weight differently.  People loose weight differently. 
With out a Dr. looking, Squeezing and testing I feel you may not get the correct answer. 

Yes, there is a guy at the centre with a fairly large chest but also rather overweight. I would have thought he had gynecomastia, and apparently so did the doctor. His ultrasound came back clear, he apparently does not have gynecomastia (he was a bit depressed over the results). 

I have seen gynecomastia with smaller chests than pseudo-gynecomastia in some people. You really need to ask your doctor about it, and most doctors won't mention anything unless asked. 

I'm not a doctor, but based on photos I think you have a reason to ask. 

Self check involves squeezing a large pinch of fat for a reference, then squeezing your breasts tissue. The breast tissue should feel firmer and rubbery compared to just fatty deposits (glandular tissue is firmer). But verify with your doctor. 

[Salsoul]

I have done the squeeze test a few times and it's certainly firmer than the love handles I also carry 😉

[gotgyne]

Long ago, a doctor in this forum wrote, that in most cases in overweight men there is most often a mixture of fat deposits and real breast tissue. And don't forget, that the belly fat contains much of the enzyme aromatase, which converts testosterone into estrogen. The fact, that your breasts don't change much, if you lose weight, is an indicator for gynecomastia. If you had only a lipomastia the breasts would shrink considerably too.

[WPW717]

Most definitely get a serial panel of hormonal blood work done.

ESTROGEN, Testosterone, Prolactin, LH, FSH, SBGH, and thyroid panel. This will help give you a 30,000 foot view your situation and a lot of granular detail for your MD to work with. Understand that one dataset is a snapshot and serial dataset will give a trend line. There are several different pathways that can be revealed. Took me about 2 years to figure out I had MEN syndrome ( multiple Endocrine neoplasia) and the sequence of its progression led to gynecomastia.

[Midagemoobs2]

Long ago, a doctor in this forum wrote, that in most cases in overweight men there is most often a mixture of fat deposits and real breast tissue. And don't forget, that the belly fat contains much of the enzyme aromatase, which converts testosterone into estrogen. The fact, that your breasts don't change much, if you lose weight, is an indicator for gynecomastia. If you had only a lipomastia the breasts would shrink considerably too.

Agree with gotgyne's comments.  I'm shaped I lot like you are - my chest is a mix of confirmed breast tissue, fat, and muscle.  I'm pretty sure the percentages have changed of that mix have changed as I've aged/meds/etc. Breast tissue can only really be confirmed by a mammogram or ultrasound here are a couple of things to check.
You may be able to feel firmer tissue over your pectorals as well as softer fat tissue.  Another way to check (learned this recently) is to raise your arm over your head to stretch and flatten the pectoral; you may notice a conical outline that will be the breast tissue and fat.

You said you tried compression, it can definitely work for appearances, and some can provide some support.  You might try a sports bra, and that may sound counter-intuitive (or even scary if you've never tried one), but it will provide better support for walking, and running especially without the compression around the lower lungs - and I find that sports bras actually make me look more fit and more like its muscle under that fat but have the same outline of a tank tee or compression tank (I'd still wear a non-tight black tee or hoodie if cool at least, and maybe a real tank too if you perspire a lot). I would guess XL/XXL in a stretchy sports bra (you don't need heavy compression to achieve a more-fit look just some modest shaping and lifting to back where pecs would be). I was better able to go on walks and jogs.

Good luck in what ever you do and especially being as healthy as possible.