How do you define "Gynecomastia"?

[Paa_Paw]

Not long ago, I heard of a Dr. (not a regular contributor to this site) who refused to call puffy nipples gynecomastia because there was insufficient volume of glandular tissue to use the word gynecomastia.

Another used the term Gynecomastia only if there was pathology present. (This would be rare)

Others seem intent upon breaking gynecomastia into sub-types of "Pseudo Gynecomastia" and "True Gynecomastia."

Someone else will refer to type 1, type 2, etc......

The disagreement is such that I sometimes wonder if the word has a common definition or if it has fallen victim to rhetorical arguement and no longer has a meaning.

The definition which I personally favor would include any breast enlargement beyond average in a male which causes emotional stress for the person who has them.

Which usage do you favor?

[Jake]

I believe the same thing.  If it causes the nipple and/or breast to become larger than normal and causes emotional stress it qualifies as gynecomastia.  Doesn't the word roughly translate into "woman-like breasts" anyways?  A lot of men don't want a feminine chest.

But every guy defines what is normal (or average) very differently.  What one critical teenager might see as gynecomastia, an older man in his 20's or 30's might not see it the same.  Heck, I remember reading about a poster on here that said he didn't even know what he had WAS gynecomastia until seeing a program on it.  It seemed he had made it through most of his life never really seeing it as very different or bad in any way.  Talk about a beautiful oblivion.

Good question, btw.   

[headheldhigh01]

while gyne is physical in nature, i like the recognition of the mental dimension since it answers that doctor's trivialization.  most of us with "mild" cases never had the luxury of beautiful obliviousness.  miserable obliviousness is more like it, we knew it was there, we knew it made life stink, we just didn't have the luxury of knowing what it was. 

i set a very low bar.  it's breast tissue in males in any noticeable degree.  that includes cases others dismiss as insignificant.  that's all it takes. 

[DrBermant]

Not long ago, I heard of a Dr. (not a regular contributor to this site) who refused to call puffy nipples gynecomastia because there was insufficient volume of glandular tissue to use the word gynecomastia.

Another used the term Gynecomastia only if there was pathology present. (This would be rare)

Others seem intent upon breaking gynecomastia into sub-types of "Pseudo Gynecomastia" and "True Gynecomastia."

Someone else will refer to type 1, type 2, etc......

The disagreement is such that I sometimes wonder if the word has a common definition or if it has fallen victim to rhetorical arguement and no longer has a meaning.

The definition which I personally favor would include any breast enlargement beyond average in a male which causes emotional stress for the person who has them.

Which usage do you favor?

You are right, the various definitions of what actually is gynecomastia or for that matter a female breast have been murky for years.

There are many such grading systems, all fail.  When I lecture about Gynecomastia, I spend almost 5 minutes describing how all of the systems break down.  Galen who first coined the phrase was talking about fatty breasts.  When posters here ask Rate My Gynecomastia, any such rating has little value.  It is a question of how much it affects the owner than a public comment for a number.

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.  Check out the Anatomy of Gynecomastia to see typical composition.

Pseudo Gynecomastia (pseudogynecomastia) 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.

When a girl starts growing female breasts and has small buds, I wonder if that same doctor would inform the child she does not have real breasts because they are too small!  Puffy Nipple Gynecomastia is a variant of a small female breast.  For a young male or Bodybuilder with Gynecomastia even such a small contour issue can lead to teasing, stress, and major emotional concerns.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia

[Dr. Elliot Jacobs]

In my view, any excess tissue on a male chest can be called "gynecomastia."  This tissue may be breast, fat or in the vast majority of cases, a combination of both.

I agree with Dr Bermant -- the many posters who request "rate my gyne" all have some degree of gyne or they would not be asking the question.

Dr Jacobs

[Paa_Paw]

Thanks to all who have responded.

It would appear that we are in agreement that the condition is essentially defined by the person who has it. The severity of the condition has little to do with the opinion of a third party observer but depends upon the impact it has on the person involved.

[DrBermant]

Thanks to all who have responded.

It would appear that we are in agreement that the condition is essentially defined by the person who has it. The severity of the condition has little to do with the opinion of a third party observer but depends upon the impact it has on the person involved.

Actually even a system of patient defining gynecomastia can fail.  In particular the individual with Body Dysmorphic Disorder may think that a normal perfectly contoured male chest is a problem that they cannot live with and needs surgery to "fix" the problem.  This is not a situation with subtle Puffy Nipple Gynecomastia nor an issue of the problem hiding in a cool room (my exam rooms are at a standard temperature for my gynecomastia evaluations).  In this situation, surgery is not the solution and education and or therapy are better options.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia

[Paa_Paw]

Obviously you are correct and I thank you for highlighting my omission.

We occasionally get inquiries from some men who think that they have gynecomastia when they are actually quite flat chested.

The truth is that Gynecomastia is would seem to be easier to deal with than Body Dysmorphic Disorder.

[Paa_Paw]

Thank you, for a very thoughtful observation. The opinion of an honest friend would be great.

The unfortunate truth is that our friends are often prone to say what they think we want, or hope, to hear while those who are not true friends will not often pass the opportunity to say something hurtful.

[wantnewlife]

Thanks Paa-Paw for pointing me to this thread.
omg..BDD is another disease..

this is how wikipedia defines BDD:
Body dysmorphic disorder (BDD) (previously known as Dysmorphophobia[1] and sometimes referred to as Body dysmorphia) (also known as "Dysmorphic syndrome," and "Dysmorphophobia"[2]) is a psychiatric disorder in which the affected person is excessively concerned about and preoccupied by an imagined or minor defect in their physical features.

.even though I have gyne, it seems like I suffer from BDD a;sp....
I wonder if major % of guys who have gyne gets BDD?

[Paa_Paw]

I think that we who have Gynecomastia get a bit obsessive about our breast size at one time or another and that it is normal to do so. Eventually we adopt a more practical attitude and realize that we are much more than one anatomical feature. Our practical side will look into options and start to save for surgery or accept the fact that cosmetic surgery is not practical for some reason.

A person with BDD becomes obsessive about a percieved abnormal characteristic when there is actually no abnormality existing. Further, the obsession becomes greater with time. Such a person will have repeated surgeries to correct their imagined deformities. If thwarted from having surgery, this person may become violent or suicidal.

Note that being obsessive alone does not mean that a person has BDD we can all be a bit obsessive at times. Multiple surgical procedures alone is not an indicator of BDD either, sometimes multiple procedures are needed to refine the results. BDD usually specifies that a person has become obsessive about a percieved abnormal feature when impartial observers see no abnormality.

Please keep in mind that this was written by a person who is not a professional.

 

[DrBermant]

I think that we who have Gynecomastia get a bit obsessive about our breast size at one time or another and that it is normal to do so. Eventually we adopt a more practical attitude and realize that we are much more than one anatomical feature. Our practical side will look into options and start to save for surgery or accept the fact that cosmetic surgery is not practical for some reason.

A person with BDD becomes obsessive about a percieved abnormal characteristic when there is actually no abnormality existing. Further, the obsession becomes greater with time. Such a person will have repeated surgeries to correct their imagined deformities. If thwarted from having surgery, this person may become violent or suicidal.

Note that being obsessive alone does not mean that a person has BDD we can all be a bit obsessive at times. Multiple surgical procedures alone is not an indicator of BDD either, sometimes multiple procedures are needed to refine the results. BDD usually specifies that a person has become obsessive about a percieved abnormal feature when impartial observers see no abnormality.

Please keep in mind that this was written by a person who is not a professional.

 

Nice reply. 

BDD can also be a factor when there is a tiny deformity that is blown way out of proportion to impair someone's lifestyle. 

I have also made a new page about Pseudogynecomastia to stress the issues and problems with that label.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia