Lumps that are felt when grabbed but not necessarily when pressed on?

[worldindboarder3]

I always see people talking about a hard lump behind their nipples when they have gynecomastia. I have hard lumps under and around both nipples, but I only feel them really when i grab my breast, which is larger than most males since I am a healthy male who works out and weighs 165. I have this since puberty and I'm 22 years old now and still have them. Are you supposed to feel a hard lump when you push on you nipple or just when you grab your breast? I'm worried that since you can't feel much of anything when pushed, that doctors will say I do not have gynecomastia. But I'm fairly certain that I do because when I grab my breast I have huge hard lumps that hurt when pressed, it feels like its truly connected to my chest. Is it normal to only feel lumps when grabbed, rather than pushed?

[Dr. Elliot Jacobs]

Feeling for lumps is a waste of time -- it is not diagnostic of gynecomastia.  Some breast tissue can feel firm and fat can feel soft -- and often the other way around as well.

The diagnosis of gynecomastia, which I define as excess tissue on a man's chest, is often made simply by observation -- not by feeling for "lumps."

And the presence of gynecomastia, which is extremely common in the male population and a totally benign condition, does not immediately mean you must have surgery.  Rather, it becomes your choice.  Accept it and live with it -- or do something about it surgically.

Dr Jacobs

[worldindboarder3]

Ok thank you for your reply. I have read about some people getting their insurance to pay for the surgery. Is this common, or extremely hard to get your insurance to pay for the surgery?

[Dr. Elliot Jacobs]

It is extremely hard to get insurance to cover gyne surgery -- they always try to call it cosmetic.

Best to look into your particular insurance policy and read about their own requirements for gyne coverage, if any.

Dr Jacobs

[Litlriki]

Regarding insurance coverage, you need to be very cautious if you are given "prior authorization" by your insurance company for the surgery, and be sure you understand your surgeon's policy toward insurance coverage.  On rare occasion, a patient is able to get prior authorization, but it always states on the letter of authorization that "Prior approval does not guarantee payment," in which case, you will still have to pay for the surgery if the insurance decides they aren't going to cover it.  When that happens in my practice, the fees are higher than what would have been charged for a "self-pay, cosmetic" charge, since the hospital and anesthesia charge higher to the insurance company, and if they don't get paid, those charges stand and cannot be re-negotiated.  In that case, the procedure can cost 2 - 3 times what it costs when it's paid in advance.  The surgeon's fee is the same in either case.

Rick Silverman

[DrPensler]

why don't you send a photo. There are great variances in the presentation of gynecomastia .